MEDICARE: HAND & SHOULDER INSTITUTE OF FLORIDA CORPORATION

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	174400000X	Specialist	ME98412	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	64225	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1285902353
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAND & SHOULDER INSTITUTE OF FLORIDA CORPORATION

Provider Business Mailing Address
First Line	:	7394 W GULF TO LAKE HWY
Second Line	:
City	:	CRYSTAL RIVER
State	:	FL
Zip	:	34429-7802
Country	:	US
Telephone Number	:	352-564-0444
Fax Number	:	352-794-6055

Provider Business Practice Location Address
First Line	:	7394 W GULF TO LAKE HWY
Second Line	:
City	:	CRYSTAL RIVER
State	:	FL
Zip	:	34429-7802
Country	:	US
Telephone Number	:	352-564-0444
Fax Number	:	352-794-6055

Authorized Official
Title or Position	:	PROFESSIONAL PROVIDER/SURGEON
Name	:	RONALD B JOSEPH
Credential	:	MD
Telephone Number	:	352-564-0444

Provider Enumeration Date	:	12/05/2011
Last Update Date	:	12/05/2011

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Directions to “HAND & SHOULDER INSTITUTE OF FLORIDA CORPORATION ” Practice Location

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