Healthcare Provider Details

I. General information

NPI: 1821113192
Provider Name (Legal Business Name): ORTHO FLORIDA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 GLADES RD STE 190
BOCA RATON FL
33431-6463
US

IV. Provider business mailing address

PO BOX 978766
DALLAS TX
75397-8766
US

V. Phone/Fax

Practice location:
  • Phone: 561-391-5515
  • Fax: 561-347-7470
Mailing address:
  • Phone: 561-300-1792
  • Fax: 561-300-1879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: SKYLER FIERRO
Title or Position: CEO
Credential:
Phone: 561-300-1779