Advanced Surgical & Weight Loss Institute LLC
Organization Active NPI Surgery Physician · Rockledge, FL
NPI 1376965822 · NPPES record last updated Jun 12, 2024
Key facts
- NPI
- 1376965822
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- License
- ME 94651 (FL)
- Legal business name
- ADVANCED SURGICAL & WEIGHT LOSS INSTITUTE LLC
- Practice address
- 3165 Suntree Blvd Ste 101
Rockledge, FL 32955-5720 - Phone
- (321) 549-2000
- Fax
- (321) 549-2142
- NPI assigned
- Jan 16, 2014
- Organization subpart
- No
Authorized official
- Name
- Diego Velarde, MD
- Title
- Owner
- Phone
- (321) 549-2000
Practitioners 1
-
Diego Velarde, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140310001167 | FL | Part B Supplier - Clinic/Group Practice | 2769612969 |
Receives reassigned benefits from 1 practitioner Practice locations: Rockledge, FL |
National Provider Directory
Locations
375 S Courtenay Pkwy
Ste 7A
Merritt Island, FL 32952
Phone (321) 454-7722
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/IBCFCA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician |
208600000X | ME 94651 | FL | Yes |
Addresses
Primary practice location
3165 Suntree Blvd Ste 101
Rockledge, FL 32955-5720
Mailing address
3165 Suntree Blvd Ste 101
Rockledge, FL 32955-5720
Phone (321) 549-2000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000052100 | Medicaid | FL |
Other providers in Rockledge, FL
- Diego Acosta-Rubio
- John Michael Adams
- Stephanie Ann Adams
- Adaptive Behavioral Health LLC
- Abosede Olatoyosi Adeoshun
- Saroj Aggarwal
- Hani M Agrama
- Francisco Javier Aguilo-Seara
- Akmal Ahmed
- Mariana Al Nasser
All providers in Rockledge, FL · Surgery Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.