Provider Demographics
NPI:1700155918
Name:ORLANDO PUENTE MD PA
Entity Type:Organization
Organization Name:ORLANDO PUENTE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:PUENTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-596-0600
Mailing Address - Street 1:8955 SW 87TH CT
Mailing Address - Street 2:SUITE 112
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176
Mailing Address - Country:US
Mailing Address - Phone:305-596-0600
Mailing Address - Fax:305-598-7965
Practice Address - Street 1:8955 SW 87TH CT
Practice Address - Street 2:SUITE 112
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176
Practice Address - Country:US
Practice Address - Phone:305-596-0600
Practice Address - Fax:305-598-7965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-16
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL044813300Medicaid
FL044813300Medicaid