Healthcare Provider Details
I. General information
NPI: 1275588204
Provider Name (Legal Business Name): HEMORRHOID CENTER OF SOUTH FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16800 NW 2ND AVE SUITE 606
NORTH MIAMI BEACH FL
33169-5549
US
IV. Provider business mailing address
1950 OLD GALLOWS RD SUITE 220
VIENNA VA
22182-3990
US
V. Phone/Fax
- Phone: 305-492-2226
- Fax: 305-493-3338
- Phone: 703-556-6620
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
KENNETH
MARK
ABRAMOWITZ
Title or Position: DIRECTOR
Credential:
Phone: 703-556-6620