Provider Demographics
NPI:1003103276
Name:SOUTH FLORIDA SURGERY AND HAND CARE LLC
Entity Type:Organization
Organization Name:SOUTH FLORIDA SURGERY AND HAND CARE LLC
Other - Org Name:AVENTURA HAND CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:LIDIA
Authorized Official - Last Name:ZULOAGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-519-4263
Mailing Address - Street 1:20895 E DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1427
Mailing Address - Country:US
Mailing Address - Phone:786-519-4263
Mailing Address - Fax:305-454-9390
Practice Address - Street 1:20895 E DIXIE HWY
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1427
Practice Address - Country:US
Practice Address - Phone:786-519-4263
Practice Address - Fax:786-228-4040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-07
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 110115261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3376055OtherUNITED
FL1087938OtherCAREPLUS
FL634037OtherHARMONY/STAYWELL/WELLCARE
FL004465700Medicaid
FL1415OtherPOSITIVE HEALTHCARE
FL349608OtherAVMED
FL58569OtherHEALTHSUN
FLQSEGWOtherBCBS
FL58569OtherHEALTHSUN