Provider Demographics
NPI:1205846730
Name:SOUTH FLORIDA HAND AND ORTHOPAEDIC CENTER PA
Entity Type:Organization
Organization Name:SOUTH FLORIDA HAND AND ORTHOPAEDIC CENTER PA
Other - Org Name:SOUTH FLORIDA HAND AND ORTHOPAEDIC CENTER PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:GARROD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-241-4758
Mailing Address - Street 1:1905 CLINT MOORE RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-2658
Mailing Address - Country:US
Mailing Address - Phone:561-241-4758
Mailing Address - Fax:561-998-4246
Practice Address - Street 1:1905 CLINT MOORE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-2658
Practice Address - Country:US
Practice Address - Phone:561-241-4758
Practice Address - Fax:561-998-4246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME44003174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3915700001Medicare NSC
FLCB6500Medicare PIN
FLK2217Medicare ID - Type UnspecifiedMEDICARE