Organization Active NPI

Miami Beach Surgical Associates LLC

  • Surgery Physician
  • Miami Beach, FL
National Provider Identifier
1932429263
Registry record updated Jun 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
MIAMI BEACH SURGICAL ASSOCIATES LLC
Practice address
4302 Alton Rd
Suite 630
Miami Beach, FL 33140-2891
Phone
(305) 673-2405
Fax
(954) 964-6084
NPI assigned
Jun 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2010

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

Authorized official

Name
Dr. Irvin H Willis, MD
Title
Managing Partner
Phone
(305) 673-2405

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

4302 Alton Rd
Suite 630
Miami Beach, FL 33140-2891

Mailing address

PO Box 816759
Hollywood, FL 33081-0759
Phone (305) 674-1233

National Provider Directory

National Provider Directory

Locations

4302 Alton Rd
Ste 630
Miami Beach, FL 33140
Phone (305) 534-6050

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1276041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276041600000",
    "number": "1932429263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 816759",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330810759",
            "telephone_number": "305-674-1233",
            "fax_number": "954-964-6084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4302 ALTON RD",
            "address_2": "SUITE 630",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331402891",
            "telephone_number": "305-673-2405",
            "fax_number": "954-964-6084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIAMI BEACH SURGICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-09",
        "last_updated": "2010-06-09",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "IRVIN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "305-673-2405",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; 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.