Healthcare Provider Details

I. General information

NPI: 1114479755
Provider Name (Legal Business Name): FLORIDA ORTHOPEDIC & INJURY CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2016
Last Update Date: 03/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 SW 148TH AVE SUITE 200
MIRAMAR FL
33027-4169
US

IV. Provider business mailing address

3000 SW 148TH AVE SUITE 200
MIRAMAR FL
33027-4169
US

V. Phone/Fax

Practice location:
  • Phone: 954-430-4210
  • Fax: 954-430-6210
Mailing address:
  • Phone: 954-430-4210
  • Fax: 954-430-6210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberOS9738
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberME110115
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State

VIII. Authorized Official

Name: LYDIA POSADA
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 954-961-0511