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General NPI Number Information
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NPI Number | 1053692277
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Entity Type | Organization
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Legal Business Name | DP INTEGRATED CARE
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Dates
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Enumeration Date | 09/01/2011
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Last Update Date | 09/01/2011
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Provider Practice Location Address
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Address Line | 3550 BISCAYNE BLVD SUITE 600
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City | MIAMI
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State | FL
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Zip | 33137-3841
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Country | US
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Telephone | 786-445-0810
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Fax | 786-217-1409
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Provider Business Mailing Address
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Address Line | 3550 BISCAYNE BLVD SUITE 600
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City | MIAMI
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State | FL
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Zip | 33137-3841
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Country | US
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Telephone | 786-445-0810
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Fax | 786-217-1409
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Authorized Official
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Title or Position | PARTNER
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Name | DR. KOSTIYA PEKI
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Credential | MD
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Telephone | 305-546-8251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME95910
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License Number State | FL
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