Healthcare Provider Details

I. General information

NPI: 1669598538
Provider Name (Legal Business Name): VERITY ORTHOPEDICS AND SPINE SURGERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 11/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 SANDLAKE COMMONS BLVD STE 220
ORLANDO FL
32819-8050
US

IV. Provider business mailing address

7300 SANDLAKE COMMONS BLVD SUITE 220
ORLANDO FL
32819-8050
US

V. Phone/Fax

Practice location:
  • Phone: 407-248-8000
  • Fax: 407-248-8909
Mailing address:
  • Phone: 407-248-8000
  • Fax: 407-248-8909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberME92118
License Number StateFL

VIII. Authorized Official

Name: JONATHAN D BLACK
Title or Position: PRESIDENT
Credential: MD
Phone: 407-248-8000