Provider Demographics
NPI:1598900755
Name:FLORIDA INTERNATIONAL JOINT INSTITUTE
Entity Type:Organization
Organization Name:FLORIDA INTERNATIONAL JOINT INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:G
Authorized Official - Last Name:HANDAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-276-3401
Mailing Address - Street 1:101 NW 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-2684
Mailing Address - Country:US
Mailing Address - Phone:561-276-3401
Mailing Address - Fax:
Practice Address - Street 1:101 NW 1ST AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33444-2684
Practice Address - Country:US
Practice Address - Phone:561-276-3401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-02
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME65791207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F33362Medicare UPIN