Healthcare Provider Details

I. General information

NPI: 1487804027
Provider Name (Legal Business Name): MIAMI BEACH SURGICAL ASSISTANTS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2008
Last Update Date: 09/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 ALTON RD
MIAMI BEACH FL
33140-2800
US

IV. Provider business mailing address

5835 SW 128TH CT
MIAMI FL
33183-5422
US

V. Phone/Fax

Practice location:
  • Phone: 305-408-4271
  • Fax:
Mailing address:
  • Phone: 305-408-4271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. ELIO PERAZA
Title or Position: PRESIDENT
Credential: F.M.G.
Phone: 305-989-5675