Healthcare Provider Details

I. General information

NPI: 1952597700
Provider Name (Legal Business Name): THE ORTHOPAEDIC INSTITUTE, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2007
Last Update Date: 04/11/2022
Certification Date: 04/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 SW ORTHOPEDIC CT
LAKE CITY FL
32024-0672
US

IV. Provider business mailing address

4500 W NEWBERRY RD
GAINESVILLE FL
32607-2245
US

V. Phone/Fax

Practice location:
  • Phone: 352-336-6000
  • Fax:
Mailing address:
  • Phone: 352-336-6000
  • Fax: 352-332-0799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL A ANDERSON
Title or Position: CFO
Credential:
Phone: 352-366-6000