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
1	207XS0117X	Orthopaedic Surgery of the Spine Physician	ME111052	FL

General Provider Information

NPI Number	:	1629413885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORTHO FLORIDA, LLC

Provider Business Mailing Address
First Line	:	660 GLADES ROAD
Second Line	:	SUITE 460
City	:	BOCA
State	:	FL
Zip	:	33431-6469
Country	:	US
Telephone Number	:	305-467-5678
Fax Number	:

Provider Business Practice Location Address
First Line	:	7150 W 20TH AVE
Second Line	:	SUITE 209
City	:	HIALEAH
State	:	FL
Zip	:	33016-5531
Country	:	US
Telephone Number	:	305-467-5678
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. JASON TOCCI
Credential	:
Telephone Number	:	954-410-5194

Provider Enumeration Date	:	05/01/2013
Last Update Date	:	05/09/2013

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Directions to “ORTHO FLORIDA, LLC ” Practice Location

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