Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Physician's Institute of Cosmetic and Reconstructive Surgery

Organization Specialist · NPI 1770787087

Physician's Institute of Cosmetic and Reconstructive Surgery is a Specialist in Hollywood, Florida. Licensed in Florida. Registered with an NPI since 2007.

Licensed in
FL
In the registry since
2007
Specialties on file
2

Practice location Address checks out

3449 Johnson St
Hollywood, FL 33021-5420
Phone: (954) 964-4113
Fax: (954) 963-8121
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence ME62894 (FL)
Specialist Taxonomy 174400000X · Licence ME64761 (FL)

Record details

NPI number1770787087
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Wanda Ditthardt — Office Manager · (954) 964-4113
NPI enumeratedJune 12, 2007
Last updated in NPPESAugust 22, 2020
Mailing address3449 Johnson St, Hollywood, FL 33021-5420

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