Organization
AVENTURA SURGICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANNON MICHELLE SMITH (OFFICE MANAGER)
(305) 933-8622
Entity
Organization
Contact information
Practice address
21110 BISCAYNE BLVD STE 400, AVENTURA, FL 33180-1252
(305) 933-8622
(305) 682-8430
Mailing address
21110 BISCAYNE BLVD STE 400, AVENTURA, FL 33180-1252
(305) 933-8622
(305) 682-8430
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OS0003845
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004770
NEIGHBORHOOD
FL
01
—
08983
WELLCARE
FL
01
—
20965953
AETNA
FL
01
—
211520
AVMED
FL
01
—
4996600003
CIGNA
FL
01
—
82412
BLUECROSS BLUE SHIELD
FL
01
—
AMERIGROUP
AMERIGROUP
FL
Enumeration date
06/18/2007
Last updated
08/22/2020
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