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Organization

THE CENTER FOR FACIAL RESTORATION, INCORPORATED

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICHARD E DAVIS MD, FACS (PRESIDENT)
(954) 442-5191
Entity
Organization

Contact information

Practice address
1951 SW 172ND AVENUE, SUITE 205, MIRAMAR, FL 33029-5613
(954) 442-5191
(786) 228-2853
Mailing address
1951 SW 172ND AVENUE, SUITE 205, MIRAMAR, FL 33029-5613
(954) 442-5191
(786) 228-2853

Taxonomy

Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
ME64358
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1346275443
INDIVIDUAL NPI
FL
Enumeration date
07/30/2015
Last updated
07/30/2015
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