Healthcare Provider Details

I. General information

NPI: 1811372097
Provider Name (Legal Business Name): ARTHROS,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2015
Last Update Date: 11/20/2020
Certification Date: 11/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12535 SOUTH DIXIE HIGHWAY
PINECREST FL
33156
US

IV. Provider business mailing address

12535 SOUTH DIXIE HIGHWAY
PINECREST FL
33156
US

V. Phone/Fax

Practice location:
  • Phone: 786-678-0601
  • Fax:
Mailing address:
  • Phone: 786-678-0601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberME-88609
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. EDUARDO J LUIS
Title or Position: MANAGER LLC
Credential:
Phone: 786-678-0601