Healthcare Provider Details
I. General information
NPI: 1316303613
Provider Name (Legal Business Name): FLORIDA ORTHOCARE NETWORK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/04/2016
Last Update Date: 02/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9325 GLADES RD STE 104
BOCA RATON FL
33434-3988
US
IV. Provider business mailing address
11211 PROSPERITY FARMS RD STE B104
PALM BEACH GARDENS FL
33410-3453
US
V. Phone/Fax
- Phone: 561-588-9912
- Fax: 561-828-2908
- Phone: 561-537-4526
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207T00000X |
| Taxonomy | Neurological Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOHN
PAPA
Title or Position: DOCTOR
Credential: MD
Phone: 561-801-2535