BROWARD ORAL SURGERY PA (NPI# 1568095255) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568095255 |
| Entity Type | Organization |
| Organization Name | BROWARD ORAL SURGERY PA |
| Practice Address |
3157 N University Dr Ste 104 Pembroke Pines FL 33024-2258 |
| Practice Telephone | 9544311600 |
| Practice Fax Number | 9544327994 |
| Mailing Telephone | 9544311600 |
| Mailing Fax Number | 9544327994 |
| Enumeration Date | 2020-02-20 |
| Last Update Date | 2020-02-20 |
| Authorized Official Name | DR. LAITH AZZOUNI (OWNER) |
| Authorized Official Telephone | 9544311600 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
Ambulatory Health Care Facilities |
| Street Address |
3157 N UNIVERSITY DR STE 104 |
| City | PEMBROKE PINES |
| State | FL |
| Zip Code | 33024-2258 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720603467 | Brooke Davignon | Behavioral Analyst | 1800 N Douglas Rd, Pembroke Pines, FL 33024 | 2020-06-09 |
| 1710527296 | Kids Miracle Steps, Inc. | Skilled Nursing Facility | 1371-1381 N Palm Ave., Pembroke Pines, FL 33024 | 2020-01-13 |
| 1992263636 | Cortney D Johnson | Social Worker | 1773 Nw 74th Way, Hollywood, FL 33024 | 2019-03-12 |
| 1760964613 | Family Medical Supplies LLC | Durable Medical Equipment & Medical Supplies | 7777 Davie Rd Ext, Ste 302 A-z, Hollywood, FL 33024 | 2018-09-06 |
| 1639650427 | Delone Elizabeth Plummer | Nurse Practitioner | 3157 N Univesity Dr, Pembroke Pines, FL 33024 | 2018-08-28 |
| 1467943126 | Bl Medical Center, Inc | Dermatology | 9050 Pines Blvd Ste 363, Pembroke Pines, FL 33024 | 2018-05-29 |
| 1952890360 | Rosmery Perez | Behavior Technician | 6610 Meade St, Hollywood, FL 33024 | 2018-05-02 |
| 1447747134 | Joseph P Robert | Technician, Health Information | 8471 Nw19th St, Pembroke Pines, FL 33024 | 2018-04-18 |
| 1164929329 | Yanelis Gutierrez Rodriguez | Behavior Technician | 321 Nw 78t Terrace Apt 104, Apt104 B32, Pembroke Pines, FL 33024 | 2018-04-12 |
| 1134621949 | Llc Tm's Care Enterprise | Clinic/Center | 9113-9117 Taft Street, Pembroke Pines, FL 33024 | 2018-03-07 |
| Find all providers in zip 33024 | ||||
| Taxonomy Code | 261QS0112X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952490484 | Seider & Stevens Pa | Clinic/Center | 3157 N University Dr, Suite 104, Pembroke Pines, FL 33024 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447875968 | Aq Surgery LLC | Clinic/Center | 14050 Integra Dr Apt 1134, Jacksonville, FL 32218-2666 | 2020-06-10 |
| 1497221352 | Ac O&m Services LLC | Clinic/Center | 4675 Van Dyke Rd, Lutz, FL 33558-4880 | 2018-10-18 |
| 1326549080 | Dental Designs of Naples LLC | Clinic/Center | 5048 Tamiami Trl N Ste A, Naples, FL 34103-2836 | 2018-02-27 |
| 1407395361 | Barry C Levine Dmd Pa | Clinic/Center | 5212 E Fowler Ave, Temple Terrace, FL 33617-2147 | 2017-02-13 |
| 1760722474 | Oral and Facial Surgery of Florida, Inc. | Clinic/Center | 19051 Us Highway 441, Suite 104, Mount Dora, FL 32757-6708 | 2013-02-18 |
| 1316211196 | Trevisani Oral Surgery | Clinic/Center | 511 Wekiva Commons Cir, Apopka, FL 32712-3645 | 2012-02-27 |
| 1386957744 | Regina H. Saenz, Dds, Pa | Clinic/Center | 950 N Krome Ave Ste 204, Homestead, FL 33030-4455 | 2010-07-14 |
| 1598883043 | Philip Marciano, M.d., P.a. | Clinic/Center | 9975 Tamiami Trl N, #4, Naples, FL 34108-1942 | 2007-03-26 |
| 1073143731 | Swan Oral & Facial Surgery, LLC | Clinic/Center | 407 S Kentucky Ave, Lakeland, FL 33801-5301 | 2020-01-22 |
| 1780150938 | Jose Luis Beltran Dmd Md LLC | Clinic/Center | 11424 N 56th St, Temple Terrace, FL 33617-2237 | 2018-10-15 |
| Find all providers with the same taxonomy | ||||
| City | PEMBROKE PINES |
| Zip Code | 33024 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.