Provider Demographics
NPI:1073928388
Name:SFM SURGERY XIV
Entity Type:Organization
Organization Name:SFM SURGERY XIV
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAJIV
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-795-9845
Mailing Address - Street 1:3343 STATE ROAD 7
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33449-8002
Mailing Address - Country:US
Mailing Address - Phone:561-795-9845
Mailing Address - Fax:561-795-8791
Practice Address - Street 1:5258 LINTON BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6540
Practice Address - Country:US
Practice Address - Phone:561-654-1004
Practice Address - Fax:561-791-8742
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTH FLORIDA MEDICINE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-25
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty