Organization
ADVANCED GENERAL SURGERY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INDREK MIIDLA M.D. (PRESIDENT)
(954) 227-2030
Entity
Organization
Contact information
Practice address
983 N UNIVERSITY DR, CORAL SPRINGS, FL 33071-7048
(954) 227-2030
(954) 227-2010
Mailing address
983 N UNIVERSITY DR, CORAL SPRINGS, FL 33071-7048
(954) 227-2030
(954) 227-2010
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273180100
—
FL
Enumeration date
06/11/2006
Last updated
09/12/2008
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