Healthcare Provider Details

I. General information

NPI: 1265494553
Provider Name (Legal Business Name): CORAL VIEW SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 12/19/2024
Certification Date: 12/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8390 W FLAGLER ST SUITE 216
MIAMI FL
33144-2039
US

IV. Provider business mailing address

8390 W FLAGLER ST STE 221
MIAMI FL
33144-2039
US

V. Phone/Fax

Practice location:
  • Phone: 305-551-8763
  • Fax: 305-221-9066
Mailing address:
  • Phone: 305-226-5574
  • Fax: 305-221-9066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number874
License Number StateFL

VIII. Authorized Official

Name: MARIA T PINEDA
Title or Position: ADMINISTRATOR
Credential:
Phone: 305-226-5574