| Craniofacial, Reconstructive And Cosmetic Surgery Associates, Llc | |
|
6705 Sw 57th Ave Ste 510 South Miami FL 33143-3644 | |
| (786) 471-4299 | |
| Not Available |
| Full Name | Craniofacial, Reconstructive And Cosmetic Surgery Associates, Llc |
|---|---|
| Speciality | Oral & Maxillofacial Surgery |
| Location | 6705 Sw 57th Ave Ste 510, South Miami, Florida |
| Authorized Official Name and Position | Stone R Thayer (PRESIDENT) |
| Authorized Official Contact | 7864714299 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Craniofacial, Reconstructive And Cosmetic Surgery Associates, Llc 1949 Isla De Palma Cir Naples FL 34119-3403 Ph: () - | Craniofacial, Reconstructive And Cosmetic Surgery Associates, Llc 6705 Sw 57th Ave Ste 510 South Miami FL 33143-3644 Ph: (786) 471-4299 |
| NPI Number | 1447673173 |
|---|---|
| Provider Enumeration Date | 01/31/2014 |
| Last Update Date | 01/24/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447673173 | NPI | - | NPPES |
| PENDING | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | ME114524 (Florida) | Secondary |
| 204E00000X | Oral & Maxillofacial Surgery | ME114524 (Florida) | Primary |
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