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General NPI Number Information
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NPI Number | 1568308419
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Entity Type | Organization
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Legal Business Name | ORTHO VIP LLC
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Dates
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Enumeration Date | 04/24/2026
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Last Update Date | 04/24/2026
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Provider Practice Location Address
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Address Line | 628 MAITLAND AVE
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-6834
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Country | US
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Telephone | 321-972-2932
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Fax | 321-972-2982
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Provider Business Mailing Address
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Address Line | 628 MAITLAND AVE
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-6834
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Country | US
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Telephone | 321-972-2932
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Fax | 321-972-2982
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Authorized Official
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Title or Position | PRACTICE MANAGER/CEO
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Name | MS. LEAH BOYD
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Credential |
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Telephone | 407-764-0771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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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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