Healthcare Provider Details

I. General information

NPI: 1801702881
Provider Name (Legal Business Name): SOUTH FLORIDA ORTHOPAEDICS & SPORTS MEDICINE, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4601 MILITARY TRL STE 209
JUPITER FL
33458-4837
US

IV. Provider business mailing address

4601 MILITARY TRL STE 209
JUPITER FL
33458-4837
US

V. Phone/Fax

Practice location:
  • Phone: 772-288-2400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. CHELSEA BEAN
Title or Position: CREDENTIALING ACCOUNT MANAGER
Credential:
Phone: 480-536-6426