Provider Demographics
NPI:1063164960
Name:ADVANCED SURGICAL CARE OF VIERA, LLC
Entity type:Organization
Organization Name:ADVANCED SURGICAL CARE OF VIERA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:HAMZAVI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-543-3688
Mailing Address - Street 1:8240 DEVEREUX DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-8200
Mailing Address - Country:US
Mailing Address - Phone:321-543-3688
Mailing Address - Fax:
Practice Address - Street 1:8240 DEVEREUX DR STE 100
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-8200
Practice Address - Country:US
Practice Address - Phone:321-543-3688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical