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General NPI Number Information
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NPI Number | 1831749977
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Entity Type | Organization
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Legal Business Name | IMED SURGICAL OF MIAMI PA
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Dates
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Enumeration Date | 09/19/2019
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 1820 E COMMERCIAL BLVD
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City | FT LAUDERDALE
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State | FL
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Zip | 33308-3725
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Country | US
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Telephone | 305-615-3311
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1970
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City | NEW YORK
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State | NY
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Zip | 10156-1970
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Country | US
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Telephone | 631-479-3496
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Fax | 917-791-9672
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Authorized Official
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Title or Position | CLINICAL COMPLIANCE MANAGER
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Name | JENNIFER R MYERS
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Credential |
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Telephone | 631-479-3496
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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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