MEDICARE: LAREDO ORTHOPAEDICS & SPORTS MEDICINE, 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	K9860	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0042HG	OTHER	TX	BCBS ID
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437214418
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAREDO ORTHOPAEDICS & SPORTS MEDICINE, PA

Provider Business Mailing Address
First Line	:	PO BOX 450224
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78045-0005
Country	:	US
Telephone Number	:	956-727-7100
Fax Number	:	956-727-4747

Provider Business Practice Location Address
First Line	:	6930 SPRINGFIELD AVE
Second Line	:	UNIT #2
City	:	LAREDO
State	:	TX
Zip	:	78041-2312
Country	:	US
Telephone Number	:	956-727-7100
Fax Number	:	956-727-4747

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOAQUIN FRANCISCO ORONOZ JR.
Credential	:	M.D.
Telephone Number	:	956-727-7100

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	03/02/2012

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