Organization
PETERSEN MEDICAL CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE PETERSEN DO (PRESIDENT)
(305) 846-9303
Entity
Organization
Contact information
Practice address
7235 CORAL WAY STE 213, MIAMI, FL 33155-1452
(305) 846-9303
(305) 640-5705
Mailing address
7235 CORAL WAY STE 213, MIAMI, FL 33155-1452
(305) 846-9303
(305) 640-5705
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Enumeration date
01/26/2018
Last updated
01/26/2018
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