Provider Demographics
NPI:1366848954
Name:SFM SURGERY XI
Entity Type:Organization
Organization Name:SFM SURGERY XI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-795-9845
Mailing Address - Street 1:3343 STATE ROAD 7
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33449-8002
Mailing Address - Country:US
Mailing Address - Phone:561-795-9845
Mailing Address - Fax:561-791-8742
Practice Address - Street 1:4000 HOLLYWOOD BLVD
Practice Address - Street 2:SUITE 160 NORTH
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6751
Practice Address - Country:US
Practice Address - Phone:954-986-6366
Practice Address - Fax:561-791-8742
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTH FLORIDA MEDICINE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-11-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty