Provider Demographics
NPI:1053692277
Name:DP INTEGRATED CARE
Entity type:Organization
Organization Name:DP INTEGRATED CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KOSTIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-546-8251
Mailing Address - Street 1:3550 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-3841
Mailing Address - Country:US
Mailing Address - Phone:786-445-0810
Mailing Address - Fax:786-217-1409
Practice Address - Street 1:3550 BISCAYNE BLVD
Practice Address - Street 2:SUITE 600
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-3841
Practice Address - Country:US
Practice Address - Phone:786-445-0810
Practice Address - Fax:786-217-1409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-01
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95910207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty