Provider Demographics
NPI:1235523689
Name:CENTRAL FLORIDA ORTHOPAEDIC, LLC
Entity Type:Organization
Organization Name:CENTRAL FLORIDA ORTHOPAEDIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRET
Authorized Official - Middle Name:GENTER
Authorized Official - Last Name:SCHEUPLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-221-6690
Mailing Address - Street 1:222 BROADWAY UNIT 202
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-5760
Mailing Address - Country:US
Mailing Address - Phone:407-910-2380
Mailing Address - Fax:407-624-5811
Practice Address - Street 1:2206 E COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-4912
Practice Address - Country:US
Practice Address - Phone:407-839-1045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty