Provider Demographics
NPI:1386917292
Name:INTERNATIONAL SURGICAL AND MEDICAL ASSOCIATES, LLC
Entity type:Organization
Organization Name:INTERNATIONAL SURGICAL AND MEDICAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MCC
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:B
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-268-8289
Mailing Address - Street 1:4770 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 880
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-3202
Mailing Address - Country:US
Mailing Address - Phone:786-268-8289
Mailing Address - Fax:786-268-4561
Practice Address - Street 1:4770 BISCAYNE BLVD
Practice Address - Street 2:SUITE 880
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-3202
Practice Address - Country:US
Practice Address - Phone:786-268-8289
Practice Address - Fax:786-268-4561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-23
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty