=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518136753
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FLOYD A OSTERMAN JR MD P A
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/21/2008
-----------------------------------------------------
Last Update Date | 04/22/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 21000 NE 28TH AVE STE 202
-----------------------------------------------------
City | AVENTURA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33180-1421
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-932-7800
-----------------------------------------------------
Fax | 305-932-9166
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 21000 NE 28TH AVE STE 202
-----------------------------------------------------
City | AVENTURA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33180-1421
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-932-7800
-----------------------------------------------------
Fax | 305-932-9166
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | FLOYD A OSTERMAN JR.
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 305-932-7800
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2085R0204X
-----------------------------------------------------
Taxonomy Name | Vascular & Interventional Radiology Physician
-----------------------------------------------------
License Number | ME30374
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------