MEDICARE: MIAMI ASC LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center	779	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114907920
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIAMI ASC LP

Provider Business Mailing Address
First Line	:	5101 SW 8TH ST
Second Line	:	1ST FLOOR
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-2442
Country	:	US
Telephone Number	:	305-461-1881
Fax Number	:	305-445-2406

Provider Business Practice Location Address
First Line	:	5101 SW 8TH ST
Second Line	:	1ST FLOOR
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-2442
Country	:	US
Telephone Number	:	305-461-1881
Fax Number	:	305-445-2406

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MARIA T PINEDA
Credential	:
Telephone Number	:	305-461-1881

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	01/28/2025

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Directions to “MIAMI ASC LP ” Practice Location

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