The Center for Facial Restoration, Incorporated

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

ME64358 Issued in FL

Legal business name

THE CENTER FOR FACIAL RESTORATION, INCORPORATED

Practice address

1951 SW 172ND Avenue
Suite 205
Miramar, FL 33029-5613

Phone

(954) 442-5191

Fax

(786) 228-2853

NPI assigned

Jul 30, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Richard E Davis, MD, FACS

Title

President

Phone

(954) 442-5191

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1438214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438214400000",
    "number": "1861877979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1951 SW 172ND AVENUE",
            "address_2": "SUITE 205",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330295613",
            "telephone_number": "954-442-5191",
            "fax_number": "786-228-2853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 SW 172ND AVENUE",
            "address_2": "SUITE 205",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330295613",
            "telephone_number": "954-442-5191",
            "fax_number": "786-228-2853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CENTER FOR FACIAL RESTORATION, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-30",
        "last_updated": "2015-07-30",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-442-5191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, FACS"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "FL",
            "license": "ME64358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1346275443",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Otolaryngology/Facial Plastic Surgery Physician in Miramar, FL
• Providers in Miramar, FL by specialty
• Otolaryngology/Facial Plastic Surgery Physician in Florida

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