Provider Demographics
NPI:1770824971
Name:OMSA SATELLITE SERVICES
Entity Type:Organization
Organization Name:OMSA SATELLITE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:A
Authorized Official - Last Name:PEREZ-ROSICH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-693-0026
Mailing Address - Street 1:10173 W SUNRISE BLVD
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-7617
Mailing Address - Country:US
Mailing Address - Phone:954-693-0026
Mailing Address - Fax:954-693-0085
Practice Address - Street 1:12001 SW 128TH CT STE 204
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4666
Practice Address - Country:US
Practice Address - Phone:954-693-0026
Practice Address - Fax:954-693-0085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty