Organization
PREMIERE CENTER FOR COSMETIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA TRAUTMAN (PRACTICE MANAGER)
(813) 305-9100
Entity
Organization
Contact information
Practice address
3930 PENDER DR, SUITE 120, FAIRFAX, VA 22030-0985
(703) 752-6608
Mailing address
2419 W KENNEDY BLVD STE 101, TAMPA, FL 33609-3481
(813) 400-1465
(813) 386-0513
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
10/09/2007
Last updated
07/31/2023
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