Healthcare Provider Details

I. General information

NPI: 1285567024
Provider Name (Legal Business Name): ORTHO FLORIDA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 37TH PL STE 202
VERO BEACH FL
32960-4818
US

IV. Provider business mailing address

PO BOX 978766
DALLAS TX
75397-8766
US

V. Phone/Fax

Practice location:
  • Phone: 772-226-8224
  • Fax:
Mailing address:
  • Phone: 561-300-1787
  • Fax:

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: DANE TRASK
Title or Position: OF CEO
Credential:
Phone: 813-767-1128