Provider Demographics
NPI:1487627642
Name:SURGERY CENTER OF CORAL GABLES LLC
Entity Type:Organization
Organization Name:SURGERY CENTER OF CORAL GABLES LLC
Other - Org Name:SURGERY CENTER OF CORAL GABLES LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:J
Authorized Official - Last Name:ARAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-442-2020
Mailing Address - Street 1:1097 S LE JEUNE RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2675
Mailing Address - Country:US
Mailing Address - Phone:305-461-1300
Mailing Address - Fax:305-442-7364
Practice Address - Street 1:1097 S LE JEUNE RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2675
Practice Address - Country:US
Practice Address - Phone:305-461-1300
Practice Address - Fax:305-442-7364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-08
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL836261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL070948400Medicaid
FL10-C0001211Medicare Oscar/Certification
FLF1211Medicare PIN