Provider Demographics
NPI:1801158274
Name:KEYS PLASTIC SURGERY, INC.
Entity type:Organization
Organization Name:KEYS PLASTIC SURGERY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:VERGHESE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-289-1975
Mailing Address - Street 1:10095 OVERSEAS HWY
Mailing Address - Street 2:
Mailing Address - City:MARATHON
Mailing Address - State:FL
Mailing Address - Zip Code:33050-3336
Mailing Address - Country:US
Mailing Address - Phone:305-289-1975
Mailing Address - Fax:305-289-1976
Practice Address - Street 1:10095 OVERSEAS HWY
Practice Address - Street 2:
Practice Address - City:MARATHON
Practice Address - State:FL
Practice Address - Zip Code:33050-3336
Practice Address - Country:US
Practice Address - Phone:305-289-1975
Practice Address - Fax:305-289-1976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME818362082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1275698201OtherNPI
FLH44085Medicare UPIN