Provider Demographics
NPI:1174170914
Name:VIP SURGERIES
Entity type:Organization
Organization Name:VIP SURGERIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HABIBI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:754-216-0788
Mailing Address - Street 1:1301 E BROWARD BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-2111
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1301 E BROWARD BLVD STE 220
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-2111
Practice Address - Country:US
Practice Address - Phone:954-595-2292
Practice Address - Fax:754-216-0788
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHO VIP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-26
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty