Provider Demographics
NPI:1669632592
Name:UNIVERSAL SURGICAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:UNIVERSAL SURGICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:FLEITES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-856-1002
Mailing Address - Street 1:3661 S MIAMI AVE
Mailing Address - Street 2:SUITE 708
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4236
Mailing Address - Country:US
Mailing Address - Phone:305-856-1002
Mailing Address - Fax:
Practice Address - Street 1:3661 S MIAMI AVE
Practice Address - Street 2:SUITE 708
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4236
Practice Address - Country:US
Practice Address - Phone:305-856-1002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-13
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0070014208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty