Basic Information
| Provider Information | |||||||||
| NPI: | 1285748657 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HYDE | ||||||||
| FirstName: | JONATHAN | ||||||||
| MiddleName: | ALLEN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4308 ALTON RD | ||||||||
| Address2: | SUITE 830 | ||||||||
| City: | MIAMI BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331404556 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055320065 | ||||||||
| FaxNumber: | 3055329793 | ||||||||
| Practice Location | |||||||||
| Address1: | 4308 ALTON RD | ||||||||
| Address2: | SUITE 830 | ||||||||
| City: | MIAMI BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331404556 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055320065 | ||||||||
| FaxNumber: | 3055329793 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2006 | ||||||||
| LastUpdateDate: | 01/23/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | ME0076225 | FL | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.