Healthcare Provider Details

I. General information

NPI: 1275975575
Provider Name (Legal Business Name): THOMAS SATTERWHITE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2013
Last Update Date: 07/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 SW 62ND AVE SUITE 2230
MIAMI FL
33155-3009
US

IV. Provider business mailing address

3100 SW 62ND AVE SUITE 2230
MIAMI FL
33155-3009
US

V. Phone/Fax

Practice location:
  • Phone: 650-387-3208
  • Fax:
Mailing address:
  • Phone: 650-387-3208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberME115309
License Number StateFL

VIII. Authorized Official

Name: THOMAS SATTERWHITE
Title or Position: PHYSICIAN
Credential:
Phone: 650-387-3208