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General NPI Number Information
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NPI Number | 1003370016
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Entity Type | Organization
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Legal Business Name | ENDO SURGICAL LLC
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Dates
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Enumeration Date | 01/23/2019
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Last Update Date | 01/23/2019
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Provider Practice Location Address
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Address Line | 3181 CORAL WAY STE 301
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City | CORAL GABLES
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State | FL
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Zip | 33145-3249
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Country | US
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Telephone | 305-856-1002
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Fax |
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Provider Business Mailing Address
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Address Line | 19537 SW 79TH CT
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City | CUTLER BAY
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State | FL
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Zip | 33157-7497
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Country | US
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Telephone | 305-856-1002
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DIANA ISABEL ORTIZ
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Credential | MD
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Telephone | 305-856-1002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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