Organization
SACRE COEUR SURGICAL PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH W MICHIENZI MD (OWNER)
(305) 662-0699
Entity
Organization
Contact information
Practice address
6705 S RED RD STE 418, SOUTH MIAMI, FL 33143-3644
(305) 669-4426
(305) 665-8736
Mailing address
1101 BRICKELL AVE UNIT 310897, MIAMI, FL 33231-1245
(305) 662-0699
(305) 665-8736
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
—
—
208200000X
Plastic Surgery Physician
Primary
ME99835
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000752600
—
FL
Enumeration date
01/29/2009
Last updated
08/12/2019
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