Provider Demographics
NPI:1184985947
Name:SOUTH BEACH PHYSICIANS LLC
Entity type:Organization
Organization Name:SOUTH BEACH PHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-662-7111
Mailing Address - Street 1:1691 MICHIGAN AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-2520
Mailing Address - Country:US
Mailing Address - Phone:305-538-3828
Mailing Address - Fax:
Practice Address - Street 1:1691 MICHIGAN AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-2520
Practice Address - Country:US
Practice Address - Phone:305-538-3828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty