MEDICARE: FLORIDA JOINT REPLACEMENT CENTER NEW PORT RICHEY, LLP

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		FL

General Provider Information

NPI Number	:	1669588737
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA JOINT REPLACEMENT CENTER NEW PORT RICHEY, LLP

Provider Business Mailing Address
First Line	:	5243 HANFF LN
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-4226
Country	:	US
Telephone Number	:	727-848-4249
Fax Number	:	727-841-8934

Provider Business Practice Location Address
First Line	:	5243 HANFF LN
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-4226
Country	:	US
Telephone Number	:	727-848-4249
Fax Number	:	727-841-8934

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. ANN R MOFFIT
Credential	:
Telephone Number	:	727-848-4249

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	08/22/2020

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