Healthcare Provider Details

I. General information

NPI: 1114079738
Provider Name (Legal Business Name): ORTHOPEDIC CENTER OF PALM BEACH COUNTY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 JFK DR STE 100
ATLANTIS FL
33462-6641
US

IV. Provider business mailing address

180 JFK DR STE 100
ATLANTIS FL
33462-6641
US

V. Phone/Fax

Practice location:
  • Phone: 561-967-6500
  • Fax: 561-472-0467
Mailing address:
  • Phone: 561-967-6500
  • Fax: 561-472-0467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA MARTINEZ
Title or Position: OPERATIONS
Credential:
Phone: 561-967-6500