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General NPI Number Information
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NPI Number | 1033255641
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Entity Type | Organization
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Legal Business Name | ORTHOPAEDIC & SPORTS MEDICINE CENTER OF MIAMI PA
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 10/31/2013
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Provider Practice Location Address
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Address Line | 6701 SUNSET DR SUITE 201
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-4529
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Country | US
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Telephone | 305-661-7601
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Fax | 305-661-0154
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Provider Business Mailing Address
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Address Line | PO BOX 430430
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City | SOUTH MIAMI
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State | FL
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Zip | 33243-0430
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Country | US
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Telephone | 305-661-7601
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Fax | 305-661-0154
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Authorized Official
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Title or Position | MANAGER
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Name | KIMBERLY BOCKMAN
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Credential |
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Telephone | 305-661-7601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | ME58988
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License Number State | FL
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