Provider Demographics
NPI:1013553080
Name:PRECISION ORTHOPEDIC SPECIALISTS, PLLC
Entity Type:Organization
Organization Name:PRECISION ORTHOPEDIC SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RETINO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:941-226-8844
Mailing Address - Street 1:201 4TH AVE E STE 4
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-1043
Mailing Address - Country:US
Mailing Address - Phone:941-226-8844
Mailing Address - Fax:941-226-8845
Practice Address - Street 1:201 4TH AVE E STE 4
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-1043
Practice Address - Country:US
Practice Address - Phone:941-226-8844
Practice Address - Fax:941-226-8845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-25
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOS516386OtherSTATE LICENSE