Provider Demographics
NPI:1033553557
Name:PRESTIGE ORTHOPEDICS
Entity Type:Organization
Organization Name:PRESTIGE ORTHOPEDICS
Other - Org Name:WHITE SANDS ORTHOPEDICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CINTIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNOZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-686-6201
Mailing Address - Street 1:1245 W FAIRBANKS AVE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-7111
Mailing Address - Country:US
Mailing Address - Phone:877-941-0111
Mailing Address - Fax:954-785-1191
Practice Address - Street 1:1245 W FAIRBANKS AVE
Practice Address - Street 2:SUITE 350
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-7111
Practice Address - Country:US
Practice Address - Phone:877-941-0111
Practice Address - Fax:954-785-1191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-26
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty