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General NPI Number Information
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NPI Number | 1275904344
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Entity Type | Organization
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Legal Business Name | PEACE HEALTH INSTITUTE CORP
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Dates
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Enumeration Date | 10/14/2015
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Last Update Date | 05/10/2017
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Provider Practice Location Address
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Address Line | 6447 MIAMI LAKES DR E STE 222E
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2764
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Country | US
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Telephone | 305-401-4728
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Fax | 305-402-0422
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Provider Business Mailing Address
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Address Line | 6447 MIAMI LAKES DR E STE 222E
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2764
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Country | US
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Telephone | 305-401-4728
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Fax | 305-402-0422
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Authorized Official
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Title or Position | PRESIDENT
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Name | ORLANDO A PEREZ
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Credential |
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Telephone | 305-401-4728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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