MEDICARE: NATIONAL ORTHOPAEDIC INSTITUTE, INC.

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	261Q00000X	Clinic/Center	HCC5402	FL

General Provider Information

NPI Number	:	1447300082
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL ORTHOPAEDIC INSTITUTE, INC.

Provider Business Mailing Address
First Line	:	6349 BEACH BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-2707
Country	:	US
Telephone Number	:	904-721-1919
Fax Number	:	904-721-1914

Provider Business Practice Location Address
First Line	:	6349 BEACH BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-2707
Country	:	US
Telephone Number	:	904-721-1919
Fax Number	:	904-721-1914

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. STEVE L BARNES
Credential	:
Telephone Number	:	904-721-1919

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	09/19/2011

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