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General NPI Number Information
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NPI Number | 1396073714
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Entity Type | Organization
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Legal Business Name | PREMIER ORTHOPEDIC & NEUROSURGICAL GROUP, LLC
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Dates
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Enumeration Date | 11/23/2009
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Last Update Date | 03/01/2010
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Provider Practice Location Address
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Address Line | 9085 SW 87TH AVE STE 205
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City | MIAMI
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State | FL
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Zip | 33176-2309
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Country | US
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Telephone | 305-598-7800
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Fax | 305-598-7802
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Provider Business Mailing Address
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Address Line | 9085 SW 87TH AVE STE 205
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City | MIAMI
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State | FL
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Zip | 33176-2309
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Country | US
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Telephone | 305-598-7800
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Fax | 305-598-7802
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JEFFREY OPPENHEIMER
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Credential | M.D.
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Telephone | 305-598-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | ME60083
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License Number State | FL
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