Healthcare Provider Details
I. General information
NPI: 1386626422
Provider Name (Legal Business Name): SURGERY SPECIALISTS OF BROWARD INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/15/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
350 NW 84TH AVE #311
PLANTATION FL
33324-1817
US
IV. Provider business mailing address
PO BOX 451986
SUNRISE FL
33345-1986
US
V. Phone/Fax
- Phone: 954-476-9899
- Fax: 954-476-9180
- Phone: 954-838-2371
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208C00000X |
| Taxonomy | Colon & Rectal Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LEWIS
GOLD
Title or Position: PRESIDENT
Credential: M.D.
Phone: 954-838-2371