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General NPI Number Information
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NPI Number | 1548431463
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Entity Type | Organization
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Legal Business Name | ORTHOPAEDIC ASSOCIATES OF SOUTH BROWARD,PA
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Dates
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Enumeration Date | 03/19/2008
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Last Update Date | 03/19/2008
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Provider Practice Location Address
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Address Line | 1625 SE 3RD AVE SUITE 707
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City | FT LAUDERDALE
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State | FL
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Zip | 33316-2521
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Country | US
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Telephone | 954-986-6334
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Fax |
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Provider Business Mailing Address
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Address Line | 1625 SE 3RD AVE SUITE 707
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City | FT LAUDERDALE
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State | FL
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Zip | 33316-2521
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Country | US
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Telephone | 954-986-6334
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Fax |
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Authorized Official
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Title or Position | V.P.
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Name | WARREN GROSSMAN
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Credential | M.D.
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Telephone | 954-986-6334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO3022
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License Number State | FL
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