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NPI Code Detail

MEDICARE: TFPS IV, L.L.C.

MEDICARE: TFPS IV, L.L.C.
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
1207XS0114XAdult Reconstructive Orthopaedic Surgery Physician
2207XX0004XOrthopaedic Foot and Ankle Surgery Physician
3207XX0005XSports Medicine (Orthopaedic Surgery) Physician
4207X00000XOrthopaedic Surgery Physician

General Provider Information

NPI Number : 1174998629
Entity Type Code : Organization
Provider Name (Legal Business Name) : TFPS IV, L.L.C.
Provider Business Mailing Address
First Line : 9960 CENTRAL PARK BLVD N
Second Line : STE 400
City : BOCA RATON
State : FL
Zip : 33428-1759
Country : US
Telephone Number : 561-288-5500
Fax Number : 561-482-1469
Provider Business Practice Location Address
First Line : 2307 W BROWARD BLVD
Second Line : STE 200
City : FT LAUDERDALE
State : FL
Zip : 33312-1417
Country : US
Telephone Number : 954-792-1010
Fax Number : 954-792-1199
Authorized Official
Title or Position : CEO
Name : MS. CYNTHIA MCCAULEY
Credential :
Telephone Number : 561-288-5500
Provider Enumeration Date : 12/09/2015
Last Update Date : 12/16/2015

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