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General NPI Number Information
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NPI Number | 1972585651
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Entity Type | Organization
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Legal Business Name | SURGERY SPECIALISTS OF BROWARD INC
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Dates
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Enumeration Date | 11/17/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7421 N UNIVERSITY DR SUITE 205
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City | TAMARAC
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State | FL
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Zip | 33321-2977
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Country | US
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Telephone | 954-476-9899
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Fax | 954-476-9180
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Provider Business Mailing Address
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Address Line | PO BOX 451986
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City | SUNRISE
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State | FL
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Zip | 33345-1986
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Country | US
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Telephone | 954-838-2371
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LEWIS GOLD
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Credential | M.D.
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Telephone | 954-838-2371
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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 |
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License Number State |
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