Provider Demographics
NPI:1376725200
Name:EXTREMITY PRESERVATION INC
Entity Type:Organization
Organization Name:EXTREMITY PRESERVATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHO SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:J
Authorized Official - Last Name:SINNREICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-534-2229
Mailing Address - Street 1:4308 ALTON RD
Mailing Address - Street 2:SUITE780
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-4556
Mailing Address - Country:US
Mailing Address - Phone:305-534-2229
Mailing Address - Fax:305-974-1955
Practice Address - Street 1:4308 ALTON RD
Practice Address - Street 2:SUITE780
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-4556
Practice Address - Country:US
Practice Address - Phone:305-534-2229
Practice Address - Fax:305-974-1955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0037432207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL40866Medicare PIN
FL0972490001Medicare NSC