MEDICARE: WITTELS ORTHOPAEDIC & SPORTS MEDICINE CENTER PA

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
1	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician

General Provider Information

NPI Number	:	1619998853
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WITTELS ORTHOPAEDIC & SPORTS MEDICINE CENTER PA

Provider Business Mailing Address
First Line	:	1085 KANE CONCOURSE
Second Line	:
City	:	BAY HARBOR ISLANDS
State	:	FL
Zip	:	33154-2105
Country	:	US
Telephone Number	:	305-866-4664
Fax Number	:	305-861-5558

Provider Business Practice Location Address
First Line	:	1085 KANE CONCOURSE
Second Line	:
City	:	BAY HARBOR ISLANDS
State	:	FL
Zip	:	33154-2105
Country	:	US
Telephone Number	:	305-866-4664
Fax Number	:	305-861-5558

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHAEL B. WITTELS
Credential	:	M.D.
Telephone Number	:	305-866-4664

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	03/12/2024

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