MEDICARE: WEST ORANGE ORTHOPAEDICS & SPORTS MEDICINE PA

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	01537	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	CB0528	OTHER		MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	2192742	OTHER	UNITED HEALTHCARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	00331	OTHER	BC/BS
5	01084794	OTHER	AMERIGOUP
6	4557847	OTHER	AETNA
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255479937
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST ORANGE ORTHOPAEDICS & SPORTS MEDICINE PA

Provider Business Mailing Address
First Line	:	596 OCOEE COMMERCE PKWY
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-4219
Country	:	US
Telephone Number	:	407-654-3505
Fax Number	:	407-654-4956

Provider Business Practice Location Address
First Line	:	596 OCOEE COMMERCE PKWY
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-4219
Country	:	US
Telephone Number	:	407-654-3505
Fax Number	:	407-654-4956

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOSE ANTONIO TORRES
Credential	:	M.D.
Telephone Number	:	407-654-3505

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	11/24/2009

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Directions to “WEST ORANGE ORTHOPAEDICS & SPORTS MEDICINE PA ” Practice Location

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