MEDICARE: FLORIDA ATLANTIC ORTHOPEDICS 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
1	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1548427248
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA ATLANTIC ORTHOPEDICS LLC

Provider Business Mailing Address
First Line	:	PO BOX 14657
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33766-4657
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 CAMINO GARDENS BLVD
Second Line	:	SUITE 201
City	:	BOCA RATON
State	:	FL
Zip	:	33432-5823
Country	:	US
Telephone Number	:	561-394-8770
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	XAVIER ESCOBAR
Credential	:	DC
Telephone Number	:	954-729-5605

Provider Enumeration Date	:	05/20/2008
Last Update Date	:	05/20/2008

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