Provider Demographics
NPI:1659632511
Name:INSTITUTE OF ORTHOPAEDIC EXCELLENCE, INC.
Entity Type:Organization
Organization Name:INSTITUTE OF ORTHOPAEDIC EXCELLENCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUSANA
Authorized Official - Middle Name:VERONICA
Authorized Official - Last Name:PEREDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-274-3311
Mailing Address - Street 1:7860 SW 129TH TER
Mailing Address - Street 2:
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156-6154
Mailing Address - Country:US
Mailing Address - Phone:305-274-3311
Mailing Address - Fax:
Practice Address - Street 1:9000 SW 87TH CT
Practice Address - Street 2:SUITE 209
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2231
Practice Address - Country:US
Practice Address - Phone:305-274-3311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT16622225100000X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty