Provider Demographics
NPI:1366418220
Name:ORTHOPAEDIC INSTITUTE OF SOUTH FLORIDA
Entity type:Organization
Organization Name:ORTHOPAEDIC INSTITUTE OF SOUTH FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:GABY
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-874-4615
Mailing Address - Street 1:1150 CAMPO SANO AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-1174
Mailing Address - Country:US
Mailing Address - Phone:786-308-3350
Mailing Address - Fax:786-308-3362
Practice Address - Street 1:1150 CAMPO SANO AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-1174
Practice Address - Country:US
Practice Address - Phone:786-308-3350
Practice Address - Fax:786-308-3362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-28
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5805020001Medicare NSC
FL45110Medicare PIN