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General NPI Number Information
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NPI Number | 1376779561
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Entity Type | Organization
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Legal Business Name | SURGICARE OF MIRAMAR LLC
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Dates
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Enumeration Date | 06/02/2009
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 14601 SW 29TH ST SUITE 301
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City | MIRAMAR
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State | FL
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Zip | 33027-4712
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Country | US
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Telephone | 954-266-3801
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Fax |
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Provider Business Mailing Address
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Address Line | 14601 SW 29TH ST SUITE 301
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City | MIRAMAR
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State | FL
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Zip | 33027-4712
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Country | US
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Telephone | 954-266-3801
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | COLLIN LEMAISTRE
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Credential |
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Telephone | 954-266-3801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State | FL
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