Healthcare Provider Details

I. General information

NPI: 1720378144
Provider Name (Legal Business Name): ORTHOPAEDIC ASSOCIATES USA, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2011
Last Update Date: 04/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4765 SW 148TH AVENUE SUITE 401
DAVIE FL
33330-2128
US

IV. Provider business mailing address

350 N PINE ISLAND RD SUITE 200
PLANTATION FL
33324-1849
US

V. Phone/Fax

Practice location:
  • Phone: 954-707-5070
  • Fax: 954-734-1353
Mailing address:
  • Phone: 954-476-8800
  • Fax: 954-476-1362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT W BAYLIS
Title or Position: DIRECTOR
Credential: M.D.
Phone: 954-476-8800