Healthcare Provider Details
I. General information
NPI: 1841125945
Provider Name (Legal Business Name): PINNACLE SOUTH FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4308 ALTON RD STE 720
MIAMI BEACH FL
33140-4557
US
IV. Provider business mailing address
4308 ALTON RD STE 720
MIAMI BEACH FL
33140-4557
US
V. Phone/Fax
- Phone: 305-405-6910
- Fax:
- Phone: 305-405-6910
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207N00000X |
| Taxonomy | Dermatology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207NP0225X |
| Taxonomy | Pediatric Dermatology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208200000X |
| Taxonomy | Plastic Surgery Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2082S0105X |
| Taxonomy | Surgery of the Hand (Plastic Surgery) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GABRIEL
E
SALLOUM
Title or Position: SOLE MBR
Credential: MD
Phone: 305-405-6910