TAKE SHAPE SURGERY CENTER LLC
Medical Practice at 5 St, Fort Lauderdale, FL

License number
Florida FL1224
Category
Medical Practice
Type
Plastic Surgery
Owner
Name: DR. RUSSELL FRANK SASSANI MD
Title: PRESIDENT CEO
Phone: (954) 585-3800
Address
Address
4161 NW 5Th St SUITE 100, Fort Lauderdale, FL 33317
National Provider ID: 1497704985
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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TAKE SHAPE SURGERY CENTER, LLC

4161 NW 5 St SUITE 100, Fort Lauderdale, FL 33317

Registration:
Dec 13, 2004
State ID:
L04000089599
Business type:
Florida Limited Liability Company
Managing Members:
Russell Fmd Sassani (Managing Member), 4161 NW 5 St SUITE 100, Fort Lauderdale, FL 33317 (Physical),Michael J Schneider (Managing Member), 4161 NW 5 St SUITE 100, Fort Lauderdale, FL 33317 (Physical)
Agent:
Sassani, Russell F., M.d,4161 NW 5 St SUITE 100, Fort Lauderdale, FL 33317 (Physical)
EIN:
34-2026859

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