Organization · NPI-2

Bayshore Surgical Associates, LLC

Surgery · Coral Gables, FL

NPI number1649706979
StatusActive
Last updated in NPPESMay 5, 2017

Details

NPI
1649706979
Entity type
Organization (NPI-2)
Legal business name
Bayshore Surgical Associates, LLC
Organization subpart
No
Enumeration date
May 5, 2017
Last updated
May 5, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208600000X Surgery––Yes
2086S0129X ––

Practice location

3181 Coral Way
Suite 302
Coral Gables, FL 33145-3216

Phone 305-856-1002 · Fax 877-501-4190

Mailing address

3181 Coral Way
Suite 302
Coral Gables, FL 33145-3216

Phone 305-856-1002 · Fax 877-501-4190

Authorized official

Juan Carlos Fleites
President
3058561002

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