Basic Information
| Provider Information | |||||||||
| NPI: | 1699286708 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PEAK INJURY & ORTHOPEDIC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 820 PALMWAY ST | ||||||||
| Address2: | |||||||||
| City: | KISSIMMEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347444542 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4079313700 | ||||||||
| FaxNumber: | 4075677900 | ||||||||
| Practice Location | |||||||||
| Address1: | 8927 CONROY WINDERMERE RD | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328353127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8032189886 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2017 | ||||||||
| LastUpdateDate: | 11/12/2019 | ||||||||
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| AuthorizedOfficialLastName: | DEL RIO | ||||||||
| AuthorizedOfficialFirstName: | LUIS | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 4072713263 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty |
No ID Information.