Healthcare Provider Details
I. General information
NPI: 1043998313
Provider Name (Legal Business Name): BAPTIST HEALTH MEDICAL GROUP ORTHOPEDICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/07/2023
Last Update Date: 07/07/2023
Certification Date: 07/07/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8400 NW 53RD ST STE F104
DORAL FL
33166-4519
US
IV. Provider business mailing address
PO BOX 100905
ATLANTA GA
30384-8054
US
V. Phone/Fax
- Phone: 786-268-6200
- Fax: 786-533-9978
- Phone: 786-268-6200
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MATTHEW
ARSENAULT
Title or Position: CFO
Credential:
Phone: 786-662-7111