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General NPI Number Information
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NPI Number | 1174170914
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Entity Type | Organization
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Legal Business Name | VIP SURGERIES
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Dates
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Enumeration Date | 08/26/2019
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Last Update Date | 03/11/2020
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Provider Practice Location Address
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Address Line | 1301 E BROWARD BLVD STE 220
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301-2111
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Country | US
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Telephone | 954-595-2292
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Fax | 754-216-0788
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Provider Business Mailing Address
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Address Line | 1301 E BROWARD BLVD STE 220
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301-2111
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KAM HABIBI
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Credential | DO
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Telephone | 754-216-0788
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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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