Healthcare Provider Details

I. General information

NPI: 1760075410
Provider Name (Legal Business Name): OMNI HEALTH INSTITUTE FOR FUNCTIONAL AND INTEGRATIVE MEDICINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2021
Last Update Date: 02/13/2021
Certification Date: 02/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 SUNSET DR STE 305
SOUTH MIAMI FL
33143-4829
US

IV. Provider business mailing address

6200 SUNSET DR STE 305
SOUTH MIAMI FL
33143-4829
US

V. Phone/Fax

Practice location:
  • Phone: 305-665-6501
  • Fax: 305-661-1672
Mailing address:
  • Phone: 305-665-6501
  • Fax: 305-661-1672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PIERROT JEANNOT
Title or Position: CEO
Credential: MD
Phone: 305-665-6501