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Organization
ORTHOMIAMI
Active
Organization
ORTHOMIAMI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE HOMMEN (BUSINESS MANAGER)
(305) 596-2828
Entity
Organization
Contact information
Practice address
3905 NW 107TH AVE STE 403, DORAL, FL 33178-2785
(305) 596-2828
Mailing address
7800 SW 87TH AVE SUITE A110, MIAMI, FL 33173
(305) 596-2828
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
NULL
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
NULL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
Other
Enumeration date
05/08/2023
Last updated
05/08/2024
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