Healthcare Provider Details

I. General information

NPI: 1740360825
Provider Name (Legal Business Name): ORTHOPEDIC HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 09/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 SW 37TH AVE SUITE 607
MIAMI FL
33133-2700
US

IV. Provider business mailing address

2601 SW 37TH AVE SUITE 607
MIAMI FL
33133-2700
US

V. Phone/Fax

Practice location:
  • Phone: 305-445-5056
  • Fax: 305-445-2023
Mailing address:
  • Phone: 305-445-5056
  • Fax: 305-445-2023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: GREGORY N MAZZOTTA
Title or Position: PRESIDENT
Credential: D.C.
Phone: 305-445-5056