Attesor Mso LLC

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

ATTESOR MSO LLC

Practice address

3350 SW 148TH Ave Ste 146
Miramar, FL 33027-3257

Phone

(954) 237-4377

Fax

(866) 653-1953

NPI assigned

Jul 12, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Theotis V Williams

Title

Ceo

Phone

(954) 237-4412

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1562889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597276800000",
    "number": "1851943591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 SW 148TH AVE STE 146",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330273257",
            "telephone_number": "954-237-4377",
            "fax_number": "866-653-1953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 SW 148TH AVE STE 146",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330273257",
            "telephone_number": "954-237-4377",
            "fax_number": "866-653-1953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATTESOR MSO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-12",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "THEOTIS",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "954-237-4412",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Exclusive Provider Organization in Miramar, FL
• Providers in Miramar, FL by specialty
• Exclusive Provider Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.