Provider Demographics
NPI:1609937150
Name:THE FLORIDA KEYS CENTER FOR PLASTIC SURGERY
Entity Type:Organization
Organization Name:THE FLORIDA KEYS CENTER FOR PLASTIC SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LANSDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-853-0002
Mailing Address - Street 1:91550 OVERSEAS HWY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:TAVERNIER
Mailing Address - State:FL
Mailing Address - Zip Code:33070-2506
Mailing Address - Country:US
Mailing Address - Phone:305-853-0002
Mailing Address - Fax:305-853-0032
Practice Address - Street 1:91550 OVERSEAS HWY
Practice Address - Street 2:SUITE 205
Practice Address - City:TAVERNIER
Practice Address - State:FL
Practice Address - Zip Code:33070-2506
Practice Address - Country:US
Practice Address - Phone:305-853-0002
Practice Address - Fax:305-853-0032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86345208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK5965Medicare PIN
FLDO5695Medicare UPIN