Provider Demographics
NPI:1932647930
Name:ADVANCED MINIMALLY INVASIVE SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:ADVANCED MINIMALLY INVASIVE SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SANTIAGO
Authorized Official - Middle Name:
Authorized Official - Last Name:FIGUEREO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-623-2000
Mailing Address - Street 1:21097 NE 27TH COURT
Mailing Address - Street 2:SUITE 540
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1235
Mailing Address - Country:US
Mailing Address - Phone:786-623-2000
Mailing Address - Fax:786-364-0532
Practice Address - Street 1:21097 NE 27TH COURT
Practice Address - Street 2:SUITE 540
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1235
Practice Address - Country:US
Practice Address - Phone:786-623-2000
Practice Address - Fax:786-364-0532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94748207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty