Provider Demographics
NPI:1467567552
Name:INSTITUTE OF SPORTS MEDICINE AND ORTHOPAEDICS PA
Entity Type:Organization
Organization Name:INSTITUTE OF SPORTS MEDICINE AND ORTHOPAEDICS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GORIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:786-629-0910
Mailing Address - Street 1:20295 N.E. 29TH PLACE TURNBERRY BANK BLDG
Mailing Address - Street 2:SUITE 300
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180
Mailing Address - Country:US
Mailing Address - Phone:786-629-0910
Mailing Address - Fax:
Practice Address - Street 1:20295 N.E. 29TH PLACE TURNBERRY BANK BLDG
Practice Address - Street 2:SUITE 300
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180
Practice Address - Country:US
Practice Address - Phone:786-629-0910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAB746Medicare PIN