MEDICARE: TALLAHASSEE ORTHOPEDIC CLINIC III, P.L.

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	3336C0002X	Clinic Pharmacy
2	261QM2500X	Medical Specialty Clinic/Center

General Provider Information

NPI Number	:	1912861097
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TALLAHASSEE ORTHOPEDIC CLINIC III, P.L.

Provider Business Mailing Address
First Line	:	5901 E FOWLER AVE STE 100
Second Line	:
City	:	TEMPLE TERRACE
State	:	FL
Zip	:	33617-2305
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1002 N ARNOLD RD UNIT 201
Second Line	:
City	:	PANAMA CITY BEACH
State	:	FL
Zip	:	32413-2524
Country	:	US
Telephone Number	:	850-877-8174
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	RAVI S. CHARI
Credential	:
Telephone Number	:	615-579-2733

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	12/12/2025

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