Healthcare Provider Details

I. General information

NPI: 1033220728
Provider Name (Legal Business Name): ORTOPEDIA CUBANA Y CLINICA DEL PIE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 11/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5840 W FLAGLER ST SUITE 101
MIAMI FL
33144-3399
US

IV. Provider business mailing address

5840 W FLAGLER ST STE 1
MIAMI FL
33144-3399
US

V. Phone/Fax

Practice location:
  • Phone: 305-261-1382
  • Fax: 305-261-6047
Mailing address:
  • Phone: 305-261-1382
  • Fax: 305-261-6047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1383
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberORT 63
License Number StateFL

VIII. Authorized Official

Name: MARIA LUISA QUIRANTES
Title or Position: PRESIDENT
Credential: ORTHOTIC FITTER
Phone: 305-261-1382