Healthcare Provider Details

I. General information

NPI: 1255479937
Provider Name (Legal Business Name): WEST ORANGE ORTHOPAEDICS & SPORTS MEDICINE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 11/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

596 OCOEE COMMERCE PKWY
OCOEE FL
34761-4219
US

IV. Provider business mailing address

596 OCOEE COMMERCE PKWY
OCOEE FL
34761-4219
US

V. Phone/Fax

Practice location:
  • Phone: 407-654-3505
  • Fax: 407-654-4956
Mailing address:
  • Phone: 407-654-3505
  • Fax: 407-654-4956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number01537
License Number StateFL

VIII. Authorized Official

Name: MR. JOSE ANTONIO TORRES
Title or Position: PRESIDENT
Credential: M.D.
Phone: 407-654-3505