NPIMap

Organization Active NPI

Minimally Invasive Surgical Assist, Inc

  • Surgery Physician
  • Coral Springs, FL
National Provider Identifier
1467833822
Registry record updated Jun 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
PA9104564 Issued in FL
Legal business name
MINIMALLY INVASIVE SURGICAL ASSIST, INC
Practice address
936 NW 118TH LN
Coral Springs, FL 33071-5048
Phone
(954) 826-7215
NPI assigned
Jun 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2015

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

Authorized official

Name
Jackeline Placencia, PANPI 1215084058
Title
President
Phone
(954) 826-7215

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208600000X PA9104564 FL Primary

Addresses

Primary practice location

936 NW 118TH LN
Coral Springs, FL 33071-5048

Mailing address

936 NW 118TH LN
Coral Springs, FL 33071-5048
Phone (954) 826-7215

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433980800000",
    "number": "1467833822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "936 NW 118TH LN",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330715048",
            "telephone_number": "954-826-7215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "936 NW 118TH LN",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330715048",
            "telephone_number": "954-826-7215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINIMALLY INVASIVE SURGICAL ASSIST, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-11",
        "last_updated": "2015-06-11",
        "status": "A",
        "authorized_official_last_name": "PLACENCIA",
        "authorized_official_first_name": "JACKELINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-826-7215",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": "PA9104564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.