Provider Demographics
NPI:1407255136
Name:SOUTH OFFICE CORP
Entity Type:Organization
Organization Name:SOUTH OFFICE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:OSORIO
Authorized Official - Middle Name:
Authorized Official - Last Name:AIDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-429-0325
Mailing Address - Street 1:3900 NW 79TH AVE
Mailing Address - Street 2:SUITE 650
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6556
Mailing Address - Country:US
Mailing Address - Phone:786-429-0325
Mailing Address - Fax:786-364-1293
Practice Address - Street 1:3900 NW 79TH AVE
Practice Address - Street 2:SUITE 650
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6556
Practice Address - Country:US
Practice Address - Phone:786-429-0325
Practice Address - Fax:786-364-1293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty