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NPI Code Detail

MEDICARE: ORTHO FLORIDA, LLC

MEDICARE: ORTHO FLORIDA, LLC
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
1213ES0000XSports Medicine Podiatrist
2208VP0014XInterventional Pain Medicine Physician
3207X00000XOrthopaedic Surgery Physician

General Provider Information

NPI Number : 1205514114
Entity Type Code : Organization
Provider Name (Legal Business Name) : ORTHO FLORIDA, LLC
Provider Business Mailing Address
First Line : 660 GLADES RD STE 460
Second Line :
City : BOCA RATON
State : FL
Zip : 33431-6469
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5741 BEE RIDGE RD STE 450
Second Line :
City : SARASOTA
State : FL
Zip : 34233-5081
Country : US
Telephone Number : 941-951-2663
Fax Number :
Authorized Official
Title or Position : CEO
Name : DANE TRASK
Credential :
Telephone Number : 813-787-1128
Provider Enumeration Date : 07/10/2023
Last Update Date : 07/10/2023

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Directions to “ORTHO FLORIDA, LLC ” Practice Location

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