Healthcare Provider Details

I. General information

NPI: 1649659046
Provider Name (Legal Business Name): CHILDREN'S ORTHOPAEDIC & SCOLIOSIS SURGERY ASSOCIATES, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2015
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3850 TAMPA RD
PALM HARBOR FL
34684-3670
US

IV. Provider business mailing address

625 6TH AVE S STE 450
ST PETERSBURG FL
33701-4629
US

V. Phone/Fax

Practice location:
  • Phone: 727-898-2663
  • Fax: 727-568-6836
Mailing address:
  • Phone: 727-898-2663
  • Fax: 727-568-6836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. CAROL ITTIG
Title or Position: ADMINISTRATOR
Credential: MBA, FACMPE
Phone: 727-568-6840