Provider Demographics
NPI:1518071687
Name:NORTH SHORE MEDICAL CENTER CORP
Entity Type:Organization
Organization Name:NORTH SHORE MEDICAL CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:MOISES
Authorized Official - Last Name:SAFIRSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-538-8392
Mailing Address - Street 1:9526 NE 2ND AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33138-2750
Mailing Address - Country:US
Mailing Address - Phone:305-538-8392
Mailing Address - Fax:
Practice Address - Street 1:9526 NE 2ND AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:MIAMI SHORES
Practice Address - State:FL
Practice Address - Zip Code:33138-2750
Practice Address - Country:US
Practice Address - Phone:305-538-8392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL582825-7261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8538Medicare ID - Type Unspecified