Healthcare Provider Details

I. General information

NPI: 1871030023
Provider Name (Legal Business Name): FLORIDA ORTHO CARE NETWORK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2017
Last Update Date: 11/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6150 METROWEST BLVD SUITE 103
ORLANDO FL
32835-3289
US

IV. Provider business mailing address

11211 PROSPERITY FARMS RD STE B104
PALM BEACH GARDENS FL
33410-3453
US

V. Phone/Fax

Practice location:
  • Phone: 407-326-6477
  • Fax:
Mailing address:
  • Phone: 561-537-4526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN PAPA
Title or Position: OWNER
Credential:
Phone: 561-801-2535