=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992135321
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MIAMI NEUROSURGICAL INSTITUTE PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/21/2013
-----------------------------------------------------
Last Update Date | 11/21/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7600 SW 57TH AVE STE 309
-----------------------------------------------------
City | SOUTH MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33143-5427
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-661-8288
-----------------------------------------------------
Fax | 305-661-1874
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7600 SW 57TH AVE STE 309
-----------------------------------------------------
City | SOUTH MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33143-5427
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-661-8288
-----------------------------------------------------
Fax | 305-661-1874
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | DR. ALDO F BERTI
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 305-661-8288
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207T00000X
-----------------------------------------------------
Taxonomy Name | Neurological Surgery Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------