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General NPI Number Information
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NPI Number | 1538358528
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Entity Type | Organization
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Legal Business Name | MICROSURGERY INC.
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 06/04/2009
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Provider Practice Location Address
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Address Line | 875 MEADOWS RD SUITE 311
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City | BOCA RATON
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State | FL
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Zip | 33486-2349
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Country | US
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Telephone | 561-368-5488
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Fax | 561-367-0145
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Provider Business Mailing Address
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Address Line | 875 MEADOWS RD SUITE 311
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City | BOCA RATON
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State | FL
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Zip | 33486-2349
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Country | US
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Telephone | 561-368-5488
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Fax | 561-367-0145
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. DOUGLAS FLYNN MARTIN
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Credential | MD
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Telephone | 561-368-5488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | ME34683
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License Number State | FL
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