MEDICARE: DR. THEODORE SARAFOGLU M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	ME16462	FL

General Provider Information

NPI Number	:	1427093889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THEODORE SARAFOGLU M.D.

Provider Business Mailing Address
First Line	:	6201 SW 118TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33156-4823
Country	:	US
Telephone Number	:	305-661-7548
Fax Number	:	305-668-1601

Provider Business Practice Location Address
First Line	:	6201 SW 118TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33156-4823
Country	:	US
Telephone Number	:	305-661-7548
Fax Number	:	305-668-1601

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2006
Last Update Date	:	07/08/2007

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