Provider Demographics
NPI:1598300774
Name:PEAK INJURY & ORTHOPEDIC
Entity Type:Organization
Organization Name:PEAK INJURY & ORTHOPEDIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:SENEN
Authorized Official - Last Name:DEL RIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-931-3700
Mailing Address - Street 1:820 PALMWAY ST
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-4542
Mailing Address - Country:US
Mailing Address - Phone:407-931-3700
Mailing Address - Fax:407-567-7900
Practice Address - Street 1:820 PALMWAY ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4542
Practice Address - Country:US
Practice Address - Phone:407-931-3700
Practice Address - Fax:407-567-7900
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEAK INJURY & ORTHOPEDIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty