Healthcare Provider Details

I. General information

NPI: 1578162228
Provider Name (Legal Business Name): FLORIDA SURGICAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2020
Last Update Date: 10/23/2020
Certification Date: 10/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 N UNIVERSITY DR STE 204
PEMBROKE PINES FL
33024-3617
US

IV. Provider business mailing address

2301 N UNIVERSITY DR STE 204
PEMBROKE PINES FL
33024-3617
US

V. Phone/Fax

Practice location:
  • Phone: 954-372-1429
  • Fax: 954-744-4519
Mailing address:
  • Phone: 954-372-1429
  • Fax: 954-744-4519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: IHOR PIDHORECKY
Title or Position: OWNER
Credential: MD
Phone: 954-372-1429