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General NPI Number Information
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NPI Number | 1861495293
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Entity Type | Organization
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Legal Business Name | SURGICAL GROUP OF MIAMI LLC
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 07/12/2024
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Provider Practice Location Address
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Address Line | 8950 N KENDALL DR SUITE 504W
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City | MIAMI
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State | FL
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Zip | 33176-2144
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Country | US
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Telephone | 305-324-4840
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Fax | 305-545-9562
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Provider Business Mailing Address
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Address Line | PO BOX 201047
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City | DALLAS
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State | TX
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Zip | 75320-1047
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | SHARLEE LEBLEU
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Credential |
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Telephone | 480-321-7026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | AS4136633
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License Number State | FL
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