Healthcare Provider Details

I. General information

NPI: 1245974062
Provider Name (Legal Business Name): PEAK HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2022
Last Update Date: 02/08/2023
Certification Date: 02/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 WESTWARD DR
MIAMI SPRINGS FL
33166-5259
US

IV. Provider business mailing address

215 WESTWARD DR
MIAMI SPRINGS FL
33166-5259
US

V. Phone/Fax

Practice location:
  • Phone: 305-887-4494
  • Fax:
Mailing address:
  • Phone: 305-887-4494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JORGE VALCOURT
Title or Position: PRINCIPAL
Credential:
Phone: 786-386-0186