Provider Demographics
NPI:1639467103
Name:OUELLETTE GROUP PHYSICIANS FOR THE HAND
Entity Type:Organization
Organization Name:OUELLETTE GROUP PHYSICIANS FOR THE HAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:OUELLETTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-261-0222
Mailing Address - Street 1:3150 SW 38 AVE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33146-1523
Mailing Address - Country:US
Mailing Address - Phone:786-261-0222
Mailing Address - Fax:786-594-4650
Practice Address - Street 1:3150 SW 38 AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33146-1523
Practice Address - Country:US
Practice Address - Phone:786-261-0222
Practice Address - Fax:786-594-4650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-18
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME42477174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty