Healthcare Provider Details

I. General information

NPI: 1285275818
Provider Name (Legal Business Name): ORTHOPEDIX NETWORK SOLUTIONS OF SOUTH FLORIDA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2019
Last Update Date: 10/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8323 NW 12TH ST STE 115
DORAL FL
33126-1839
US

IV. Provider business mailing address

8323 NW 12TH ST STE 115
DORAL FL
33126-1839
US

V. Phone/Fax

Practice location:
  • Phone: 305-284-7484
  • Fax:
Mailing address:
  • Phone: 305-284-7484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSE PELAYO
Title or Position: CEO
Credential:
Phone: 305-284-7484