MEDICARE: FLORIDA STATE ORTHOPEDIC SPECIALISTS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1225142359
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA STATE ORTHOPEDIC SPECIALISTS LLC

Provider Business Mailing Address
First Line	:	301 CAMINO GARDENS BLVD
Second Line	:	SUITE 103
City	:	BOCA RATON
State	:	FL
Zip	:	33432-5823
Country	:	US
Telephone Number	:	561-674-6044
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 CAMINO GARDENS BLVD
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33432-5823
Country	:	US
Telephone Number	:	561-394-6044
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AMY M STARRY
Credential	:	D.O.
Telephone Number	:	561-394-8770

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	03/23/2010

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