Provider Demographics
NPI:1861641508
Name:DEERFIELD BEACH OUTPATIENT SURGICAL CENTER LLC
Entity Type:Organization
Organization Name:DEERFIELD BEACH OUTPATIENT SURGICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BAHRAM
Authorized Official - Middle Name:KAM
Authorized Official - Last Name:HABIBI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:945-742-0771
Mailing Address - Street 1:250 SW NATURA AVE
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-3029
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:250 SW NATURA AVE
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-3029
Practice Address - Country:US
Practice Address - Phone:954-742-0771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-18
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical