Broward Oral Surgery PA

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

Legal business name

BROWARD ORAL SURGERY PA

Practice address

3157 N University Dr Ste 104
Pembroke Pines, FL 33024-2258

Phone

(954) 431-1600

Fax

(954) 432-7994

NPI assigned

Feb 20, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Laith Azzouni

Title

Owner

Phone

(954) 431-1600

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582156800000",
    "number": "1568095255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3157 N UNIVERSITY DR STE 104",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330242258",
            "telephone_number": "954-431-1600",
            "fax_number": "954-432-7994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3157 N UNIVERSITY DR STE 104",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330242258",
            "telephone_number": "954-431-1600",
            "fax_number": "954-432-7994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWARD ORAL SURGERY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-20",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A",
        "authorized_official_last_name": "AZZOUNI",
        "authorized_official_first_name": "LAITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-431-1600",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Broward Home Health Care Services, Corp
• Broward Home Health Care, Inc.
• Broward Institute of Orthopaedic Specialties LLC
• Broward Institute of Orthopaedic Specialties LLC
• Broward Medical Physician Associates Inc
• Broward Primary Care LLC
• Broward Psychological Services
• Broward Psychological Services, Inc.
• Broward Senior Home Care
• Broward Surgical Center Inc

• Oral and Maxillofacial Surgery Clinic/Center in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; 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.