Provider Demographics
NPI:1073616553
Name:CENTRAL FLORIDA ORTHOPAEDICS PA
Entity Type:Organization
Organization Name:CENTRAL FLORIDA ORTHOPAEDICS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:R
Authorized Official - Last Name:LOCKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-861-9044
Mailing Address - Street 1:3040 SW 27TH AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-8981
Mailing Address - Country:US
Mailing Address - Phone:352-861-9044
Mailing Address - Fax:352-861-9544
Practice Address - Street 1:3040 SW 27TH AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-8981
Practice Address - Country:US
Practice Address - Phone:352-861-9044
Practice Address - Fax:352-861-9544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK3402Medicare ID - Type Unspecified
FL5336110001Medicare NSC