Healthcare Provider Details

I. General information

NPI: 1053842377
Provider Name (Legal Business Name): THOMAS JAMES UTSET-WARD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: THOMAS JAMES UTSET M.D.

II. Dates (important events)

Enumeration Date: 03/27/2017
Last Update Date: 07/01/2024
Certification Date: 07/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 SW 62ND AVE
MIAMI FL
33155-3009
US

IV. Provider business mailing address

3100 SW 62ND AVE
MIAMI FL
33155-3009
US

V. Phone/Fax

Practice location:
  • Phone: 305-666-6511
  • Fax:
Mailing address:
  • Phone: 305-666-6511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME168635
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License NumberME168635
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: