# THORACIC INNOVATION, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326335548
- **Authorized official:** MOSES DEGRAFT-JOHNSON M.D. (PHYSICIAN/OWNER)
- **Authorized official phone:** (340) 772-2000

## Contact information

- **Practice address:** 15053 SW 40TH ST, DAVIE, FL 33331-2769
- **Practice address phone:** (340) 772-2000
- **Mailing address:** 15053 SW 40TH ST, DAVIE, FL 33331-2769

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | ME106359 | FL | Yes |

## Other

- **Enumeration date:** 07/08/2011
- **Last updated:** 07/21/2011