Healthcare Provider Details
I. General information
NPI: 1730455130
Provider Name (Legal Business Name): ORTHO FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/29/2012
Last Update Date: 03/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9325 GLADES RD SUITE 205
BOCA RATON FL
33434-3988
US
IV. Provider business mailing address
9325 GLADES RD SUITE 205
BOCA RATON FL
33434-3988
US
V. Phone/Fax
- Phone: 561-826-2000
- Fax:
- Phone: 561-826-2000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JASON
TOCCI
Title or Position: MANAGER
Credential:
Phone: 561-300-1700