Provider Demographics
NPI:1063824704
Name:FLORIDA MUSCULOSKELETAL SURGICAL GROUP
Entity Type:Organization
Organization Name:FLORIDA MUSCULOSKELETAL SURGICAL GROUP
Other - Org Name:ORTHOCARE FLORIDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:B
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:727-347-1286
Mailing Address - Street 1:6500 66TH ST N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-5030
Mailing Address - Country:US
Mailing Address - Phone:727-347-1286
Mailing Address - Fax:727-384-8224
Practice Address - Street 1:709 16TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-1334
Practice Address - Country:US
Practice Address - Phone:727-347-1286
Practice Address - Fax:727-384-8224
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLORIDA MUSCULOSKELETAL SURGICAL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-29
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site