Healthcare Provider Details

I. General information

NPI: 1619998853
Provider Name (Legal Business Name): WITTELS ORTHOPAEDIC & SPORTS MEDICINE CENTER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1085 KANE CONCOURSE
BAY HARBOR ISLANDS FL
33154-2105
US

IV. Provider business mailing address

1085 KANE CONCOURSE
BAY HARBOR ISLANDS FL
33154-2105
US

V. Phone/Fax

Practice location:
  • Phone: 305-866-4664
  • Fax: 305-861-5558
Mailing address:
  • Phone: 305-866-4664
  • Fax: 305-861-5558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL B. WITTELS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 305-866-4664