Provider Demographics
NPI:1003201906
Name:THE ORTHOPAEDIC INSTITUTE, P.A.
Entity Type:Organization
Organization Name:THE ORTHOPAEDIC INSTITUTE, P.A.
Other - Org Name:THE ORTHOPAEDIC INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-336-6000
Mailing Address - Street 1:4500 W NEWBERRY RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-2245
Mailing Address - Country:US
Mailing Address - Phone:352-336-6000
Mailing Address - Fax:352-332-0799
Practice Address - Street 1:800 ZEAGLER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177
Practice Address - Country:US
Practice Address - Phone:352-336-6000
Practice Address - Fax:352-332-0799
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE ORTHOPAEDIC INSTITUTE, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-30
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21474Medicare PIN