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General NPI Number Information
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NPI Number | 1528397056
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE SURGERY
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Dates
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Enumeration Date | 12/11/2009
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Last Update Date | 08/03/2010
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Provider Practice Location Address
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Address Line | 4302 ALTON RD SUITE 105
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City | MIAMI BEACH
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State | FL
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Zip | 33140-2891
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Country | US
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Telephone | 786-522-9968
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Fax | 305-571-7838
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Provider Business Mailing Address
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Address Line | PO BOX 403506
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City | MIAMI BEACH
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State | FL
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Zip | 33140-1506
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Country | US
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Telephone | 786-522-9968
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Fax | 305-571-7838
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. CAROLYN BETH MESSERE
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Credential | M.D.
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Telephone | 786-522-9968
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | ME93472
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License Number State | FL
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