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General NPI Number Information
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NPI Number | 1285019547
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Entity Type | Organization
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Legal Business Name | SURGICAL INNOVATIONS OF POMPANO BEACH LLC
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Dates
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Enumeration Date | 07/28/2015
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Last Update Date | 07/28/2015
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Provider Practice Location Address
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Address Line | 1419 BANYAN CIR
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City | POMPANO BEACH
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State | FL
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Zip | 33069-4976
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Country | US
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Telephone | 954-803-7344
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Fax |
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Provider Business Mailing Address
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Address Line | 1419 BANYAN CIR
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City | POMPANO BEACH
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State | FL
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Zip | 33069-4976
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Country | US
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Telephone | 954-803-7344
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. JOSEPH PATRICK MCLOUGHLIN
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Credential |
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Telephone | 954-803-7344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | PA9102647
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License Number State | FL
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