Provider Demographics
NPI:1093933145
Name:MD SPAS
Entity Type:Organization
Organization Name:MD SPAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:ABUZENI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:3054-448-2888
Mailing Address - Street 1:248 PALERMO AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-6606
Mailing Address - Country:US
Mailing Address - Phone:305-444-2888
Mailing Address - Fax:305-444-2333
Practice Address - Street 1:248 PALERMO AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-6606
Practice Address - Country:US
Practice Address - Phone:305-444-2888
Practice Address - Fax:305-444-2333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5527941174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty