Healthcare Provider Details

I. General information

NPI: 1205537099
Provider Name (Legal Business Name): ROYAL PALM ORTHOPEDICS SPORTS MEDICINE AND INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2023
Last Update Date: 03/17/2023
Certification Date: 03/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 W KENNEDY BLVD STE 100
TAMPA FL
33609-2457
US

IV. Provider business mailing address

23781 US HIGHWAY 27 # 122
LAKE WALES FL
33859-7802
US

V. Phone/Fax

Practice location:
  • Phone: 863-324-6100
  • Fax:
Mailing address:
  • Phone: 863-324-6100
  • Fax: 863-679-9182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID U. ARANGO
Title or Position: OWNER
Credential: M. D.
Phone: 863-324-6100