Healthcare Provider Details

I. General information

NPI: 1063187771
Provider Name (Legal Business Name): SOUTH FLORIDA SURGICAL SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2021
Last Update Date: 08/13/2021
Certification Date: 07/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 N STATE ROAD 7 STE 305
MARGATE FL
33063-5737
US

IV. Provider business mailing address

3001 CORAL HILLS DR STE 320
CORAL SPRINGS FL
33065-4172
US

V. Phone/Fax

Practice location:
  • Phone: 202-415-9235
  • Fax: 754-205-7987
Mailing address:
  • Phone: 954-213-4741
  • Fax: 954-755-2209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JUSTIN C GULAREK
Title or Position: EXECUTIVE DIRECTOR
Credential: MBA
Phone: 954-213-4741