Aventura Surgical Group

Primary specialty

SpecialistTaxonomy code 174400000X

License

OS0003845 Issued in FL

Legal business name

AVENTURA SURGICAL GROUP

Practice address

21110 Biscayne Blvd Ste 400
Aventura, FL 33180-1252

Phone

(305) 933-8622

Fax

(305) 682-8430

NPI assigned

Jun 18, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Shannon Michelle Smith

Title

Office Manager

Phone

(305) 933-8622

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861697096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21110 BISCAYNE BLVD STE 400",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801252",
            "telephone_number": "305-933-8622",
            "fax_number": "305-682-8430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21110 BISCAYNE BLVD STE 400",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801252",
            "telephone_number": "305-933-8622",
            "fax_number": "305-682-8430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVENTURA SURGICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "305-933-8622",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "OS0003845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Aventura, FL
• Providers in Aventura, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.