Provider Type Icon

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
Get Directions

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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther 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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.