Healthcare Provider Details

I. General information

NPI: 1295062610
Provider Name (Legal Business Name): MIAMI HAND PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2009
Last Update Date: 07/26/2022
Certification Date: 07/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2734 SW 37TH AVE
COCONUT GROVE FL
33133
US

IV. Provider business mailing address

2734 SW 37TH AVE
COCONUT GROVE FL
33133-2728
US

V. Phone/Fax

Practice location:
  • Phone: 305-642-4263
  • Fax: 305-426-3329
Mailing address:
  • Phone: 305-642-4263
  • Fax: 305-426-3329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ROGER K KHOURI
Title or Position: OWNER
Credential: MD
Phone: 305-458-3754