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General NPI Number Information
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NPI Number | 1386687499
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Entity Type | Organization
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Legal Business Name | SOUTH DADE ORTHOPAEDIC ASSOCIATES PA
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 7867 N KENDALL DR SUITE 130
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City | MIAMI
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State | FL
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Zip | 33156-7735
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Country | US
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Telephone | 305-274-5959
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Fax | 305-275-0690
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Provider Business Mailing Address
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Address Line | 7867 N KENDALL DR SUITE 130
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City | MIAMI
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State | FL
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Zip | 33156-7735
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Country | US
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Telephone | 305-274-5959
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Fax | 305-275-0690
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Authorized Official
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Title or Position | PRESIDENT
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Name | THEODORE A EVANS
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Credential | MD
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Telephone | 305-274-5959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME36255
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME22368
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO2781
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA3551
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME96926
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME47564
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License Number State | FL
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