Provider Demographics
NPI:1881217131
Name:OMEGA ENDOCRINOLOGY LLC
Entity Type:Organization
Organization Name:OMEGA ENDOCRINOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:POOJA
Authorized Official - Middle Name:PULIN
Authorized Official - Last Name:KINKHABWALA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:630-621-5569
Mailing Address - Street 1:8215 SW 72ND AVE APT 1818
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-7877
Mailing Address - Country:US
Mailing Address - Phone:630-621-5569
Mailing Address - Fax:
Practice Address - Street 1:5040 NW 7TH ST STE 635
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-3796
Practice Address - Country:US
Practice Address - Phone:630-621-5569
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty