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General NPI Number Information
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NPI Number | 1548211972
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Entity Type | Organization
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Legal Business Name | DR. MICHAEL SURDIS, JR. P.A.
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 1561 N PALM AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-3229
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Country | US
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Telephone | 954-443-2420
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Fax | 954-443-8422
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Provider Business Mailing Address
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Address Line | 1561 N PALM AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-3229
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Country | US
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Telephone | 954-443-2420
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Fax | 954-443-8422
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MS. PENNY R FIORENTINO
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Credential |
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Telephone | 954-894-1797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH6300
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License Number State | FL
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