Provider Demographics
NPI:1508839366
Name:SOUTH FLORIDA SURGERY AND BARIATRIC INSTITUTE, PA
Entity Type:Organization
Organization Name:SOUTH FLORIDA SURGERY AND BARIATRIC INSTITUTE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:RAUL
Authorized Official - Last Name:VALLADARES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-631-5355
Mailing Address - Street 1:PO BOX 451050
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33245-1050
Mailing Address - Country:US
Mailing Address - Phone:305-631-5355
Mailing Address - Fax:305-631-5354
Practice Address - Street 1:2660 SW 3 ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135
Practice Address - Country:US
Practice Address - Phone:305-631-5355
Practice Address - Fax:305-631-5354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-10
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLQ0271Medicare UPIN