MEDICARE: LAUDERDALE ORTHOPAEDIC SURGEONS LLP

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	ME 44143	FL

General Provider Information

NPI Number	:	1336190537
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAUDERDALE ORTHOPAEDIC SURGEONS LLP

Provider Business Mailing Address
First Line	:	880 NW 13TH ST
Second Line	:	SUITE 4A
City	:	BOCA RATON
State	:	FL
Zip	:	33486-2342
Country	:	US
Telephone Number	:	954-739-4420
Fax Number	:	954-733-4092

Provider Business Practice Location Address
First Line	:	1212 E BROWARD BLVD
Second Line	:	SUITE 300
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33301-2123
Country	:	US
Telephone Number	:	954-739-4420
Fax Number	:	954-733-4092

Authorized Official
Title or Position	:	OWNER
Name	:	MICHAEL RUDDY
Credential	:	M.D.
Telephone Number	:	954-739-4420

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	07/10/2007

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