Provider Demographics
NPI:1083449326
Name:EAST COAST PLASTIC SURGERY OF FLORIDA, PLLC
Entity type:Organization
Organization Name:EAST COAST PLASTIC SURGERY OF FLORIDA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAGURTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-628-7300
Mailing Address - Street 1:175 BRADLEY PL
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33480-3785
Mailing Address - Country:US
Mailing Address - Phone:212-628-7300
Mailing Address - Fax:212-628-7302
Practice Address - Street 1:175 BRADLEY PL
Practice Address - Street 2:
Practice Address - City:PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33480-3785
Practice Address - Country:US
Practice Address - Phone:212-628-7300
Practice Address - Fax:212-628-7302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty