South Florida Institute for Laser Vaginal Rejuvenation, Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME59386 Issued in FL

Legal business name

SOUTH FLORIDA INSTITUTE FOR LASER VAGINAL REJUVENATION, INC

Practice address

7600 SW 57TH Ave
Suite 201
South Miami, FL 33143-5428

Phone

(305) 668-2853

Fax

(305) 675-2474

NPI assigned

May 30, 2008

Organization subpart

No

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

Authorized official

Name

Rafael Antun, M.D

Title

President

Phone

(305) 668-2853

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212105600000",
    "number": "1669630257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 SW 57TH AVE",
            "address_2": "SUITE 201",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331435428",
            "telephone_number": "305-668-2853",
            "fax_number": "305-675-2474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 SW 57TH AVE",
            "address_2": "SUITE 201",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331435428",
            "telephone_number": "305-668-2853",
            "fax_number": "305-675-2474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH FLORIDA INSTITUTE FOR LASER VAGINAL REJUVENATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-30",
        "last_updated": "2008-05-30",
        "status": "A",
        "authorized_official_last_name": "ANTUN",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-668-2853",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME59386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in South Miami, FL
• Providers in South Miami, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; 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.