Provider Demographics
NPI:1477694875
Name:U.S. BARIATRIC, ORLANDO, LLC
Entity Type:Organization
Organization Name:U.S. BARIATRIC, ORLANDO, 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:
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 1:7300 SANDLAKE COMMONS BLVD
Practice Address - Street 2:SUITE 327
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-8050
Practice Address - Country:US
Practice Address - Phone:407-895-8008
Practice Address - Fax:407-895-8007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty