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General NPI Number Information
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NPI Number | 1023704269
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Entity Type | Organization
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Legal Business Name | FLORIDA ORTHOPAEDIC ASSOCIATES PA
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Dates
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Enumeration Date | 04/12/2023
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Last Update Date | 01/31/2024
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Provider Practice Location Address
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Address Line | 3635 CLYDE MORRIS BLVD STE 600
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City | PORT ORANGE
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State | FL
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Zip | 32129-2353
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Country | US
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Telephone | 386-734-9122
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Fax |
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Provider Business Mailing Address
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Address Line | 740 W PLYMOUTH AVE
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City | DELAND
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State | FL
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Zip | 32720-3282
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Country | US
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Telephone | 386-734-9122
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | PAIGE L ADAMS
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Credential |
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Telephone | 386-734-9122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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