Provider Demographics
NPI:1609765759
Name:PHYSICIANS CREEK INC
Entity type:Organization
Organization Name:PHYSICIANS CREEK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO PHYSICIAN RESPONSIBLE PARTY
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:MAXWELL
Authorized Official - Last Name:AU
Authorized Official - Suffix:
Authorized Official - Credentials:DO, MD, PHD
Authorized Official - Phone:305-720-4004
Mailing Address - Street 1:2040 NE 163RD ST STE 204
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-4953
Mailing Address - Country:US
Mailing Address - Phone:305-720-4004
Mailing Address - Fax:
Practice Address - Street 1:2040 NE 163RD ST STE 204
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-4953
Practice Address - Country:US
Practice Address - Phone:305-720-4004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies