TAKE SHAPE PLASTIC SURGERY PA NPI 1972609816

NPI Information

  • NPI: 1972609816
  • Provider Name: TAKE SHAPE PLASTIC SURGERY PA
  • Classification: Plastic Surgery - 208200000X
  • Entity Type: Organization
  • CLIA Number: 10D1036668
  • Address: 4161 NW 5TH ST
    SUITE 100
    PLANTATION, FL
    ZIP 33317
  • Phone: (954) 585-3800

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NPI Details

TAKE SHAPE PLASTIC SURGERY PA is a plastic surgery in Plantation, FL. The provider is a plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. TAKE SHAPE PLASTIC SURGERY PA NPI is 1972609816. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4161 NW 5TH ST
SUITE 100
PLANTATION, FL
ZIP 33317-101
Phone: (954) 585-3800
Fax: (954) 585-6100

The provider's authorized official is Russell F Sassani .
The authorized official title is Owner and has the following contact phone number (954) 585-3800.

The CLIA number assigned to this NPI record is 10D1036668 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/16/2006 and was last updated on 7/11/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208200000XPlastic SurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1K6200MEDICARE ID-TYPE UNSPECIFIEDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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