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General NPI Number Information
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NPI Number | 1740308253
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Entity Type | Organization
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Legal Business Name | FLORIDA ORTHOPAEDIC ASSOCIATES PA
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 04/17/2024
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Provider Practice Location Address
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Address Line | 1053 MEDICAL CENTER DRIVE SUITE 101
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City | ORANGE CITY
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State | FL
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Zip | 32763
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Country | US
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Telephone | 386-774-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 740 W PLYMOUTH AVE
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City | DELAND
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State | FL
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Zip | 32720-3282
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Country | US
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Telephone | 386-734-9122
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Fax | 386-736-4348
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK W HOLLMANN
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Credential | MD
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Telephone | 386-774-2500
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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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