Provider Demographics
NPI:1063814341
Name:BTW MED, LLC
Entity Type:Organization
Organization Name:BTW MED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREEDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:ARVELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-416-1781
Mailing Address - Street 1:2901 SW 149TH AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4151
Mailing Address - Country:US
Mailing Address - Phone:954-874-4617
Mailing Address - Fax:954-239-3902
Practice Address - Street 1:2901 SW 149TH AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-4151
Practice Address - Country:US
Practice Address - Phone:954-874-4617
Practice Address - Fax:954-239-3902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty