Provider Demographics
NPI:1174284822
Name:FLORIDA ENT ASSOCIATES, INC.
Entity Type:Organization
Organization Name:FLORIDA ENT ASSOCIATES, INC.
Other - Org Name:SOUTH FLORIDA ENT ASSOCIATES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HODGKISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-558-3724
Mailing Address - Street 1:15280 NW 79TH CT STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5873
Mailing Address - Country:US
Mailing Address - Phone:305-558-3724
Mailing Address - Fax:786-907-4485
Practice Address - Street 1:1350 SW 57TH AVE STE 210
Practice Address - Street 2:
Practice Address - City:WEST MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-5768
Practice Address - Country:US
Practice Address - Phone:305-441-0744
Practice Address - Fax:305-262-8771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-05
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty