Provider Demographics
NPI:1154587202
Name:COLORECTAL SURGERY & AESTHETICS INSTITUTE INC
Entity type:Organization
Organization Name:COLORECTAL SURGERY & AESTHETICS INSTITUTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CMO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGILEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-466-9988
Mailing Address - Street 1:21150 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1226
Mailing Address - Country:US
Mailing Address - Phone:305-466-9988
Mailing Address - Fax:305-466-9989
Practice Address - Street 1:21150 BISCAYNE BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1226
Practice Address - Country:US
Practice Address - Phone:305-466-9988
Practice Address - Fax:305-466-9989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-29
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME20802208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1568428266OtherNPI