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General NPI Number Information
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NPI Number | 1912975780
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Entity Type | Organization
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Legal Business Name | ORTHOPAEDIC SPECIALISTS OF MIAMI BEACH, INC
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Dates
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Enumeration Date | 03/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4701 N MERIDIAN AVE SUITE 601
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City | MIAMI BEACH
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State | FL
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Zip | 33140-2910
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Country | US
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Telephone | 305-674-5956
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 402125
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City | MIAMI BEACH
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State | FL
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Zip | 33140-0125
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Country | US
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Telephone | 305-674-5956
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PHILIP RANDALL LOZMAN
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Credential | M.D.
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Telephone | 305-674-5956
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | ME58688
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License Number State | FL
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