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General NPI Number Information
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NPI Number | 1710566807
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Entity Type | Organization
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Legal Business Name | ORTHO FLORIDA, LLC
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Dates
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Enumeration Date | 04/06/2021
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Last Update Date | 04/06/2021
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Provider Practice Location Address
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Address Line | 1951 SW 172ND AVE STE 200
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City | MIRAMAR
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State | FL
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Zip | 33029-5613
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Country | US
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Telephone | 954-730-5030
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Fax |
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Provider Business Mailing Address
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Address Line | 433 PLAZA REAL STE 275
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City | BOCA RATON
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State | FL
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Zip | 33432-3999
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Country | US
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Telephone | 561-300-1792
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Fax |
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Authorized Official
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Title or Position | COO
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Name | ADRIANA WEICHT
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Credential |
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Telephone | 561-300-1792
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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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