Healthcare Provider Details

I. General information

NPI: 1659891018
Provider Name (Legal Business Name): POCKETDOC PHYSICIANS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 SE 2ND AVE STE 2000
MIAMI FL
33131-2185
US

IV. Provider business mailing address

333 SE 2ND AVE STE 2000
MIAMI FL
33131-2185
US

V. Phone/Fax

Practice location:
  • Phone: 305-901-5228
  • Fax: 305-901-1434
Mailing address:
  • Phone: 305-901-5228
  • Fax: 305-901-1434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: BENJAMIN TILSON
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 305-901-5228