New Image Cosmetic Surgery Center, Inc.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

NEW IMAGE COSMETIC SURGERY CENTER, INC.

Practice address

10167 W Sunrise Blvd
Suite 104
Plantation, FL 33322-7619

Phone

(954) 424-8882

Fax

(954) 424-8858

NPI assigned

Jan 29, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Maria D. Jacobson

Title

Ceo

Phone

(954) 424-8882

Specialties & licenses 1

Addresses

Other names 1

• New Image Cosmetic Surgery Center Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201564800000",
    "number": "1053598409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10167 W SUNRISE BLVD",
            "address_2": "SUITE 104",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333227619",
            "telephone_number": "954-424-8882",
            "fax_number": "954-424-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10167 W SUNRISE BLVD",
            "address_2": "SUITE 104",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333227619",
            "telephone_number": "954-424-8882",
            "fax_number": "954-424-8858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW IMAGE COSMETIC SURGERY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-29",
        "last_updated": "2008-01-29",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "954-424-8882",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Image Cosmetic Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Plantation, FL
• Providers in Plantation, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.