Healthcare Provider Details

I. General information

NPI: 1700155918
Provider Name (Legal Business Name): ORLANDO PUENTE MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2011
Last Update Date: 01/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8955 SW 87TH CT SUITE 112
MIAMI FL
33176
US

IV. Provider business mailing address

8955 SW 87TH CT SUITE 112
MIAMI FL
33176
US

V. Phone/Fax

Practice location:
  • Phone: 305-596-0600
  • Fax: 305-598-7965
Mailing address:
  • Phone: 305-596-0600
  • Fax: 305-598-7965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ORLANDO PUENTE
Title or Position: PRESIDENT/OWNER
Credential: MD
Phone: 305-596-0600