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General NPI Number Information
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NPI Number | 1598371064
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Entity Type | Organization
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Legal Business Name | ORIVE PHYSICIAN SERVICES PA
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Dates
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Enumeration Date | 09/21/2020
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 6816 SW 89TH CT
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City | MIAMI
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State | FL
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Zip | 33173-2430
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Country | US
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Telephone | 786-608-2991
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Fax | 786-894-0808
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Provider Business Mailing Address
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Address Line | 6800 SW 40TH ST # 457
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City | MIAMI
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State | FL
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Zip | 33155-3708
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Country | US
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Telephone | 786-608-2991
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICAL
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Name | MR. YORDAN ORIVE GOMEZ
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Credential | MD
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Telephone | 786-608-2991
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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 |
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License Number State |
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