Provider Demographics
NPI:1649558503
Name:PERFORMANCE ORTHOPAEDICS & NEUROSURGERY
Entity Type:Organization
Organization Name:PERFORMANCE ORTHOPAEDICS & NEUROSURGERY
Other - Org Name:CALHOUN ORTHOPAEDICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:F
Authorized Official - Last Name:FISCALETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-234-7975
Mailing Address - Street 1:2750 CORAL WAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3200
Mailing Address - Country:US
Mailing Address - Phone:954-765-3200
Mailing Address - Fax:965-765-3206
Practice Address - Street 1:2750 CORAL WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33145-3200
Practice Address - Country:US
Practice Address - Phone:954-765-3200
Practice Address - Fax:965-765-3206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-26
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty