Healthcare Provider Details

I. General information

NPI: 1740375765
Provider Name (Legal Business Name): FLORIDA CENTER FOR ORTHOPAEDIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 01/25/2025
Certification Date: 01/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7575 DR PHILLIPS BLVD STE 370
ORLANDO FL
32819-7220
US

IV. Provider business mailing address

7575 DR PHILLIPS BLVD STE 370
ORLANDO FL
32819-7220
US

V. Phone/Fax

Practice location:
  • Phone: 407-292-2156
  • Fax: 407-241-2868
Mailing address:
  • Phone: 407-292-2156
  • Fax: 407-241-2868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ADRIANA SMITH
Title or Position: ADMINISTRATOR/MANAGER
Credential:
Phone: 407-292-2156