Provider Demographics
NPI:1649588039
Name:MDSPAS INC
Entity Type:Organization
Organization Name:MDSPAS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESISENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:Z
Authorized Official - Last Name:ABUZENI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-444-2888
Mailing Address - Street 1:248 PALERMO AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-6606
Mailing Address - Country:US
Mailing Address - Phone:305-444-2888
Mailing Address - Fax:
Practice Address - Street 1:248 PALERMO AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-6606
Practice Address - Country:US
Practice Address - Phone:305-444-2888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-20
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 71711261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL69581ZOtherMEDICARE PROVIDER