Provider Demographics
NPI:1245627405
Name:BROWARD SURGICAL SERVICES INC.
Entity type:Organization
Organization Name:BROWARD SURGICAL SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PD
Authorized Official - Prefix:
Authorized Official - First Name:RONALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENCIA
Authorized Official - Suffix:
Authorized Official - Credentials:RNFA
Authorized Official - Phone:954-416-1781
Mailing Address - Street 1:16900 N BAY RD
Mailing Address - Street 2:SUITE 1401
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4252
Mailing Address - Country:US
Mailing Address - Phone:954-416-1781
Mailing Address - Fax:954-416-1782
Practice Address - Street 1:16900 N BAY RD
Practice Address - Street 2:SUITE 1401
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4252
Practice Address - Country:US
Practice Address - Phone:954-416-1781
Practice Address - Fax:954-416-1782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9216868163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRN9216868OtherLICENSE