Healthcare Provider Details

I. General information

NPI: 1447006408
Provider Name (Legal Business Name): FEDERAL ORTHOPEDIC SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2024
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 N US HIGHWAY 441 STE 906
THE VILLAGES FL
32159-6811
US

IV. Provider business mailing address

1290 WOODS LANDING DR
MINNEOLA FL
34715-6070
US

V. Phone/Fax

Practice location:
  • Phone: 352-234-8340
  • Fax: 888-477-2586
Mailing address:
  • Phone: 727-743-2111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: KEVIN KELLIN
Title or Position: PARTNER
Credential:
Phone: 727-743-2111