Provider Demographics
NPI:1689362105
Name:INSULINIC OF FLORIDA LLC
Entity Type:Organization
Organization Name:INSULINIC OF FLORIDA LLC
Other - Org Name:INSULINIC OF NORTH MIAMI BEACH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ATHANASIOS
Authorized Official - Middle Name:
Authorized Official - Last Name:SARIDIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:647-273-6484
Mailing Address - Street 1:3700 WASHINGTON ST STE 304
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-8258
Mailing Address - Country:US
Mailing Address - Phone:954-820-5860
Mailing Address - Fax:954-634-4293
Practice Address - Street 1:100 NW 170TH ST STE 411
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33169-5511
Practice Address - Country:US
Practice Address - Phone:786-885-1626
Practice Address - Fax:954-634-4293
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INSULINIC OF FLORIDA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-04-25
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty