Provider Demographics
NPI:1235709569
Name:SOUTH FLORIDA SURGICAL SPECIALISTS LLC
Entity Type:Organization
Organization Name:SOUTH FLORIDA SURGICAL SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:GULAREK
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:954-213-4741
Mailing Address - Street 1:3001 CORAL HILLS DR STE 320
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4172
Mailing Address - Country:US
Mailing Address - Phone:954-213-4741
Mailing Address - Fax:954-755-2209
Practice Address - Street 1:7950 SW 30TH ST STE 201
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-1979
Practice Address - Country:US
Practice Address - Phone:754-247-2684
Practice Address - Fax:954-252-4532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty