Healthcare Provider Details

I. General information

NPI: 1669934899
Provider Name (Legal Business Name): ELITE SURGICAL INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2019
Last Update Date: 05/15/2023
Certification Date: 05/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 TOWN CENTER CIRCLE SUITE B
WESTON FL
33326-3636
US

IV. Provider business mailing address

3150 INVERNESS
WESTON FL
33332-1816
US

V. Phone/Fax

Practice location:
  • Phone: 954-507-4494
  • Fax: 954-507-4515
Mailing address:
  • Phone: 954-507-4494
  • Fax: 954-507-4515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAVINIU ANGHEL
Title or Position: PRESIDENT
Credential: MD
Phone: 954-507-4515