Healthcare Provider Details
I. General information
NPI: 1003223322
Provider Name (Legal Business Name): OUELLETTE GROUP PHYSICIANS FOR THE HAND
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/18/2014
Last Update Date: 07/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4302 ALTON RD SUITE 710
MIAMI BEACH FL
33140-2891
US
IV. Provider business mailing address
3150 SW 38 AVE SUITE 600
MIAMI FL
33146-1523
US
V. Phone/Fax
- Phone: 786-261-0222
- Fax: 786-594-4650
- Phone: 786-261-0222
- Fax: 786-594-4650
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XS0106X |
| Taxonomy | Orthopaedic Hand Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ELIZABETH
ANNE
OUELLETTE
Title or Position: DIRECTOR/OWNER
Credential: MD
Phone: 786-261-0222