Healthcare Provider Details
I. General information
NPI: 1669086872
Provider Name (Legal Business Name): ROTHMAN ORTHOPAEDICS OF FLORIDA,PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/04/2020
Last Update Date: 01/17/2023
Certification Date: 01/17/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
265 E ROLLINS ST STE 11100
ORLANDO FL
32804-5519
US
IV. Provider business mailing address
833 CHESTNUT ST STE 520
PHILADELPHIA PA
19107-4430
US
V. Phone/Fax
- Phone: 844-407-4070
- Fax: 407-743-3050
- Phone: 609-677-7003
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QS0010X |
| Taxonomy | Sports Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHELSEY
CONWAY
Title or Position: VP FINANCE
Credential:
Phone: 267-845-4119