Healthcare Provider Details

I. General information

NPI: 1598268625
Provider Name (Legal Business Name): BAPTIST HEALTH MEDICAL GROUP ORTHOPEDICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2018
Last Update Date: 10/19/2022
Certification Date: 10/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13101 S DIXIE HWY STE 400
PINECREST FL
33156-6530
US

IV. Provider business mailing address

6855 S RED RD STE 600
SOUTH MIAMI FL
33143-3518
US

V. Phone/Fax

Practice location:
  • Phone: 786-268-6200
  • Fax:
Mailing address:
  • Phone: 786-662-7111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW ARSENAULT
Title or Position: CFO
Credential:
Phone: 786-662-7111