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General NPI Number Information
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NPI Number | 1316577638
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Entity Type | Organization
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Legal Business Name | METRO ORTHOPEDIC SPECIALISTS, LLC
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Dates
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Enumeration Date | 01/26/2020
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Last Update Date | 01/26/2020
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Provider Practice Location Address
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Address Line | 7300 SAND LAKE CMN STE 312
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City | ORLANDO
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State | FL
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Zip | 32819-8050
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Country | US
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Telephone | 850-517-7330
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Fax | 844-511-6930
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Provider Business Mailing Address
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Address Line | 859 COLDWATER CREEK CIR
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City | NICEVILLE
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State | FL
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Zip | 32578-1653
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Country | US
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Telephone | 850-517-7330
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Fax | 844-511-6930
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Authorized Official
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Title or Position | OWNER/EMPLOYEE
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Name | DR. PETER J GODLESKI
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Credential | MD
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Telephone | 850-517-7330
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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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