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General NPI Number Information
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NPI Number | 1871690354
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Entity Type | Organization
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Legal Business Name | ADVANCED ORTHOPEDIC SURGERY & SPORTS MEDICINE, INC.
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Dates
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Enumeration Date | 09/19/2006
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Last Update Date | 11/23/2021
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Provider Practice Location Address
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Address Line | 5258 LINTON BLVD. 305
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City | DELRAY BEACH
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State | FL
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Zip | 33484
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Country | US
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Telephone | 954-251-6051
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Fax | 310-824-7600
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Provider Business Mailing Address
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Address Line | 5258 LINTON BLVD. 305
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City | DELRAY BEACH
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State | FL
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Zip | 33484
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Country | US
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Telephone | 954-251-6051
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Fax | 310-824-7600
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Authorized Official
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Title or Position | SURGEON
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Name | DR. CHRISTINE KOHLER EKSTRAND
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Credential | M.D.
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Telephone | 954-251-6051
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | A71116
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License Number State | CA
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