Healthcare Provider Details

I. General information

NPI: 1376725200
Provider Name (Legal Business Name): EXTREMITY PRESERVATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2007
Last Update Date: 11/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4308 ALTON RD SUITE780
MIAMI BEACH FL
33140-4556
US

IV. Provider business mailing address

4308 ALTON RD SUITE780
MIAMI BEACH FL
33140-4556
US

V. Phone/Fax

Practice location:
  • Phone: 305-534-2229
  • Fax: 305-974-1955
Mailing address:
  • Phone: 305-534-2229
  • Fax: 305-974-1955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberME0037432
License Number StateFL

VIII. Authorized Official

Name: MARK J SINNREICH
Title or Position: ORTHO SURGEON
Credential: MD
Phone: 305-534-2229