Healthcare Provider Details

I. General information

NPI: 1396865606
Provider Name (Legal Business Name): MICHELE RAUL D'APUZZO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 01/16/2020
Certification Date: 01/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 NW 12TH AVE STE 600
MIAMI FL
33136-1005
US

IV. Provider business mailing address

1611 NW 12TH AVE STE 600
MIAMI FL
33136-1005
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-6262
  • Fax:
Mailing address:
  • Phone: 305-585-6262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberME119693
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number270462
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: