Provider Demographics
NPI:1154485548
Name:ALLIED ORTHOPEDICS, INC.
Entity Type:Organization
Organization Name:ALLIED ORTHOPEDICS, INC.
Other - Org Name:PEDIATRIC ORTHOPEDIC DESIGNS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HERNAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LUNA
Authorized Official - Suffix:
Authorized Official - Credentials:CPO, LPO
Authorized Official - Phone:305-828-3090
Mailing Address - Street 1:5753 MIAMI LAKES DR E
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2417
Mailing Address - Country:US
Mailing Address - Phone:305-828-3090
Mailing Address - Fax:
Practice Address - Street 1:5753 MIAMI LAKES DR E
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2417
Practice Address - Country:US
Practice Address - Phone:305-828-3090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPOR155335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL025605600Medicaid
FL025605600Medicaid