# SURGICAL GROUP OF MIAMI LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Miami Vascular Specialists
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861495293
- **Authorized official:** SHARLEE LEBLEU (VICE PRESIDENT)
- **Authorized official phone:** (480) 321-7026

## Contact information

- **Practice address:** 8950 N KENDALL DR, SUITE 504W, MIAMI, FL 33176-2144
- **Practice address phone:** (305) 324-4840
- **Practice address fax:** (305) 545-9562
- **Mailing address:** PO BOX 201047, DALLAS, TX 75320-1047

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | AS4136633 | FL | Yes |

## Other

- **Enumeration date:** 05/31/2005
- **Last updated:** 07/12/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00216 | BLUE SHIELD | FL |
| 05 | — | 060796-700 | — | FL |