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General NPI Number Information
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NPI Number | 1194086892
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Entity Type | Organization
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Legal Business Name | INNOVATIVE ORTHOPEDICS OF CENTRAL FLORIDA
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Dates
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Enumeration Date | 05/30/2012
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Last Update Date | 05/30/2012
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Provider Practice Location Address
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Address Line | 1701 SE HILLMOOR DR STE A1
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-7540
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Country | US
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Telephone | 888-960-7567
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Fax | 772-335-7841
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Provider Business Mailing Address
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Address Line | 1701 SE HILLMOOR DR STE A1
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-7540
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Country | US
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Telephone | 888-960-7567
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Fax | 772-335-7841
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Authorized Official
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Title or Position | MANAGER
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Name | RONALD J SILVERBERG
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Credential | DC
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Telephone | 888-960-7567
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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 | ME42808
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License Number State | FL
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