Provider Demographics
NPI:1205130119
Name:MINIMALLY INVASIVE SURGICAL ASSOCIATES OF SOUTH FLORIDA PLLC
Entity type:Organization
Organization Name:MINIMALLY INVASIVE SURGICAL ASSOCIATES OF SOUTH FLORIDA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:I
Authorized Official - Last Name:GARBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-495-0660
Mailing Address - Street 1:4675 LINTON BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-6615
Mailing Address - Country:US
Mailing Address - Phone:561-495-0660
Mailing Address - Fax:561-495-0677
Practice Address - Street 1:4675 LINTON BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-6615
Practice Address - Country:US
Practice Address - Phone:561-495-0660
Practice Address - Fax:561-495-0677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty