Organization
MIAMI BEACH SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GABRIEL ELLIS SALLOUM (PRESIDENT)
(305) 742-7985
Entity
Organization
Contact information
Practice address
400 W 41ST ST STE 512, MIAMI BEACH, FL 33140-3517
(305) 405-6910
(305) 405-6912
Mailing address
400 W 41ST ST STE 512, MIAMI BEACH, FL 33140-3517
(305) 405-6910
(305) 405-6912
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1578188983
OUT OF NETWORK PROVIDER
FL
Enumeration date
06/11/2020
Last updated
09/04/2020
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