Provider Demographics
NPI:1306083332
Name:ORTHOPAEDIC AND SPINAL ASSOCIATES OF SOUTH FLORIDA PA
Entity type:Organization
Organization Name:ORTHOPAEDIC AND SPINAL ASSOCIATES OF SOUTH FLORIDA PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:C
Authorized Official - Last Name:WINDLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-532-2411
Mailing Address - Street 1:4308 ALTON RD
Mailing Address - Street 2:SUITE 830
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2840
Mailing Address - Country:US
Mailing Address - Phone:305-532-2411
Mailing Address - Fax:
Practice Address - Street 1:4308 ALTON RD
Practice Address - Street 2:SUITE 830
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2840
Practice Address - Country:US
Practice Address - Phone:305-532-2411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-13
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty