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General NPI Number Information
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NPI Number | 1912932047
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Entity Type | Organization
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Legal Business Name | ORTHOPEDIC CENTER OF FLORIDA, INC
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 12/30/2022
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Provider Practice Location Address
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Address Line | 12670 CREEKSIDE LANE SUITE 202
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City | FORT MYERS
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State | FL
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Zip | 33919-8759
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Country | US
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Telephone | 239-482-2663
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Fax | 239-482-7585
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Provider Business Mailing Address
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Address Line | 12670 CREEKSIDE LANE SUITE 202
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City | FORT MYERS
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State | FL
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Zip | 33919-8759
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Country | US
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Telephone | 239-482-2663
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Fax | 239-482-7585
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Authorized Official
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Title or Position | VP
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Name | MR. MARK FARMER
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Credential |
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Telephone | 239-482-2663
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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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