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NPI Code Detail

MEDICARE: TRITON MD LLC

MEDICARE: TRITON MD LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP3300XPain Clinic/Center
2208100000XPhysical Medicine & Rehabilitation Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477134088
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRITON MD LLC
Provider Business Mailing Address
First Line : 2020 PONCE DE LEON BLVD STE 103
Second Line :
City : CORAL GABLES
State : FL
Zip : 33134-4475
Country : US
Telephone Number : 786-801-3825
Fax Number : 305-508-6910
Provider Business Practice Location Address
First Line : 2020 PONCE DE LEON BLVD STE 103
Second Line :
City : CORAL GABLES
State : FL
Zip : 33134-4475
Country : US
Telephone Number : 786-801-3825
Fax Number : 305-508-6910
Authorized Official
Title or Position : PHYSICIAN/OWNER
Name : PETER MICHAEL
Credential : M.D.
Telephone Number : 305-799-8466
Provider Enumeration Date : 04/15/2021
Last Update Date : 02/17/2026

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Directions to “TRITON MD LLC ” Practice Location

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