Organization
SURIA PLASTIC SURGERY P.L.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHASHIDHAR KUSUMA M.D. (PRESIDENT)
(954) 472-8355
Entity
Organization
Contact information
Practice address
8430 W BROWARD BLVD, SUITE 200, PLANTATION, FL 33324-2700
(954) 472-8355
(954) 472-8220
Mailing address
8430 W BROWARD BLVD, SUITE 200, PLANTATION, FL 33324-2700
(954) 472-8355
(954) 472-8220
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
—
—
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
09/20/2010
Last updated
09/20/2010
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