Provider Demographics
NPI:1801963517
Name:SURF DRUGS INC
Entity type:Organization
Organization Name:SURF DRUGS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAYSON
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:RITTENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-948-6429
Mailing Address - Street 1:7430 COLLINS AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-2714
Mailing Address - Country:US
Mailing Address - Phone:305-865-2600
Mailing Address - Fax:305-866-0797
Practice Address - Street 1:7430 COLLINS AVE
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-2714
Practice Address - Country:US
Practice Address - Phone:305-865-2600
Practice Address - Fax:305-866-0797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH9593336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0402210002Medicare ID - Type UnspecifiedMEDICARE STORE