MEDICARE: FLORIDA ORTHOPAEDIC ASSOCIATES PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1023704269
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA ORTHOPAEDIC ASSOCIATES PA

Provider Business Mailing Address
First Line	:	740 W PLYMOUTH AVE
Second Line	:
City	:	DELAND
State	:	FL
Zip	:	32720-3282
Country	:	US
Telephone Number	:	386-734-9122
Fax Number	:

Provider Business Practice Location Address
First Line	:	3635 CLYDE MORRIS BLVD STE 600
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32129-2353
Country	:	US
Telephone Number	:	386-734-9122
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	PAIGE L ADAMS
Credential	:
Telephone Number	:	386-734-9122

Provider Enumeration Date	:	04/12/2023
Last Update Date	:	01/31/2024

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