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General NPI Number Information
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NPI Number | 1487227120
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Entity Type | Organization
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Legal Business Name | SOUTH FLORIDA SURGICAL SPECIALISTS LLC
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Dates
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Enumeration Date | 07/21/2021
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Last Update Date | 07/21/2021
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Provider Practice Location Address
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Address Line | 7100 CAMINO REAL STE 200
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City | BOCA RATON
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State | FL
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Zip | 33433-5510
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Country | US
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Telephone | 754-200-1617
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Fax | 954-656-0108
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Provider Business Mailing Address
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Address Line | 3001 CORAL HILLS DR STE 320
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-4172
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Country | US
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Telephone | 954-213-4741
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Fax | 954-755-2209
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JUSTIN C GULAREK
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Credential | MBA
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Telephone | 954-213-4741
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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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