Provider Demographics
NPI:1114907920
Name:MIAMI ASC LP
Entity Type:Organization
Organization Name:MIAMI ASC LP
Other - Org Name:THE ENDOSCOPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OF GENERAL PARTNER CORP.
Authorized Official - Prefix:MS
Authorized Official - First Name:BILLIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-665-1283
Mailing Address - Street 1:5101 SW 8TH ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2442
Mailing Address - Country:US
Mailing Address - Phone:305-461-1881
Mailing Address - Fax:305-445-2406
Practice Address - Street 1:5101 SW 8TH ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2442
Practice Address - Country:US
Practice Address - Phone:305-461-1881
Practice Address - Fax:305-445-2406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL779261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL079170900Medicaid
FL079170900Medicaid
FL10-C0001229Medicare Oscar/Certification
FL490003064Medicare PIN