Provider Demographics
NPI:1093950008
Name:HIMMERSHEE SURGICAL PARTNERS LLP
Entity Type:Organization
Organization Name:HIMMERSHEE SURGICAL PARTNERS LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:K
Authorized Official - Last Name:MOON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-357-1172
Mailing Address - Street 1:717 SE 2ND ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-3605
Mailing Address - Country:US
Mailing Address - Phone:954-357-1172
Mailing Address - Fax:954-337-3309
Practice Address - Street 1:717 SE 2ND ST
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-3605
Practice Address - Country:US
Practice Address - Phone:954-463-5208
Practice Address - Fax:954-337-3309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-04
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME51849208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD51132Medicare UPIN