Healthcare Provider Details

I. General information

NPI: 1366927170
Provider Name (Legal Business Name): ROYAL PALM ORTHOPEDIC & SPORTS MEDICINE INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2018
Last Update Date: 01/27/2023
Certification Date: 01/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1526 COMMERCIAL PARK DR STE 5
LAKELAND FL
33801-6568
US

IV. Provider business mailing address

23781 US HIGHWAY 27 STE 122
LAKE WALES FL
33859-7802
US

V. Phone/Fax

Practice location:
  • Phone: 863-324-6100
  • Fax: 863-679-9182
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID U. ARANGO
Title or Position: OWNER
Credential: MD
Phone: 863-324-6100