Provider Demographics
NPI:1346381845
Name:U.S. BARIATRIC, FORT LAUDERDALE, LLC
Entity Type:Organization
Organization Name:U.S. BARIATRIC, FORT LAUDERDALE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:TRENT
Authorized Official - Last Name:MAREMA
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:954-351-7770
Mailing Address - Street 1:4800 NE 20TH TER
Mailing Address - Street 2:SUITE 303
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4510
Mailing Address - Country:US
Mailing Address - Phone:954-351-7770
Mailing Address - Fax:954-351-7181
Practice Address - Street 1:4800 NE 20TH TER
Practice Address - Street 2:SUITE 303
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4510
Practice Address - Country:US
Practice Address - Phone:954-351-7770
Practice Address - Fax:954-351-7181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty