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General NPI Number Information
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NPI Number | 1477134088
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Entity Type | Organization
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Legal Business Name | TRITON MD LLC
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Dates
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Enumeration Date | 04/15/2021
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 2020 PONCE DE LEON BLVD STE 103
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City | CORAL GABLES
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State | FL
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Zip | 33134-4475
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Country | US
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Telephone | 305-224-8850
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Fax | 855-940-6025
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Provider Business Mailing Address
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Address Line | 2020 PONCE DE LEON BLVD STE 103
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City | CORAL GABLES
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State | FL
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Zip | 33134-4475
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Country | US
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Telephone | 305-224-8850
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Fax | 855-940-6025
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | PETER MICHAEL
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Credential | M.D.
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Telephone | 305-799-8466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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