Provider Demographics
NPI:1851036933
Name:PEACHTREE MEDICAL SOLUTIONS, LLC
Entity type:Organization
Organization Name:PEACHTREE MEDICAL SOLUTIONS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHRUTI
Authorized Official - Middle Name:
Authorized Official - Last Name:DESHMUKH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-600-8134
Mailing Address - Street 1:66 W FLAGLER ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-1807
Mailing Address - Country:US
Mailing Address - Phone:561-600-8134
Mailing Address - Fax:
Practice Address - Street 1:66 W FLAGLER ST STE 900
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-1807
Practice Address - Country:US
Practice Address - Phone:561-600-8134
Practice Address - Fax:786-558-2417
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEACHTREE MEDICAL SOLUTIONS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-03
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine