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NPI Code Detail

MEDICARE: ORTHO FLORIDA, LLC

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
1207XS0117XOrthopaedic Surgery of the Spine Physician
2207XX0005XSports Medicine (Orthopaedic Surgery) Physician
32081P2900XPain Medicine (Physical Medicine & Rehabilitation) Physician
4207X00000XOrthopaedic Surgery Physician

General Provider Information

NPI Number : 1932847720
Entity Type Code : Organization
Provider Name (Legal Business Name) : ORTHO FLORIDA, LLC
Provider Business Mailing Address
First Line : 433 PLAZA REAL STE 275
Second Line :
City : BOCA RATON
State : FL
Zip : 33432-3999
Country : US
Telephone Number : 561-300-1792
Fax Number :
Provider Business Practice Location Address
First Line : 5800 CORPORATE WAY
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33407-2004
Country : US
Telephone Number : 561-495-9511
Fax Number :
Authorized Official
Title or Position : CEO
Name : DANE TRASK
Credential :
Telephone Number : 813-747-1128
Provider Enumeration Date : 05/23/2022
Last Update Date : 05/23/2022

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Directions to “ORTHO FLORIDA, LLC ” Practice Location

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