Provider Demographics
NPI:1407981830
Name:ROBERT B CONTRUCCI D O P A
Entity Type:Organization
Organization Name:ROBERT B CONTRUCCI D O P A
Other - Org Name:SOUTHERN EAR NOSE THROAT AND SINUS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CYNDI
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-437-5333
Mailing Address - Street 1:1172 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2918
Mailing Address - Country:US
Mailing Address - Phone:305-432-3440
Mailing Address - Fax:786-946-2831
Practice Address - Street 1:10071 PINES BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6181
Practice Address - Country:US
Practice Address - Phone:954-437-5333
Practice Address - Fax:954-437-6252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1677Medicare PIN