Provider Demographics
NPI:1679760292
Name:SURGICAL SKIN SPECIALISTS OF SOUTH FLORIDA LLC
Entity Type:Organization
Organization Name:SURGICAL SKIN SPECIALISTS OF SOUTH FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:CABRERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-393-6400
Mailing Address - Street 1:951 NW 13TH ST
Mailing Address - Street 2:SUITE 4-B
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2359
Mailing Address - Country:US
Mailing Address - Phone:561-393-6400
Mailing Address - Fax:561-393-7688
Practice Address - Street 1:951 NW 13TH ST
Practice Address - Street 2:SUITE 4-B
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2359
Practice Address - Country:US
Practice Address - Phone:561-393-6400
Practice Address - Fax:561-393-7688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical