Organization
SOUTH DADE ORTHOPAEDIC ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEODORE A EVANS MD (PRESIDENT)
(305) 274-5959
Entity
Organization
Contact information
Practice address
7867 N KENDALL DR, SUITE 130, MIAMI, FL 33156-7735
(305) 274-5959
(305) 275-0690
Mailing address
7867 N KENDALL DR, SUITE 130, MIAMI, FL 33156-7735
(305) 274-5959
(305) 275-0690
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
ME22368
FL
207X00000X
Orthopaedic Surgery Physician
ME36255
FL
207X00000X
Orthopaedic Surgery Physician
Primary
ME47564
FL
207X00000X
Orthopaedic Surgery Physician
ME96926
FL
213E00000X
Podiatrist
PO2781
FL
363A00000X
Physician Assistant
PA3551
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
206419
AVMED
—
05
—
2777739800
—
FL
01
—
38941
BCBS
—
01
—
54511
JMH
—
01
—
7574
OWCP
—
01
—
CR 16002400
OWCP
—
01
—
DA2535
RAILRAOD MEDICARE
—
Enumeration date
06/14/2006
Last updated
04/20/2008
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