Provider Demographics
NPI:1346212743
Name:FIRST RESPONSE ORTHOPAEDIC GROUP INC
Entity Type:Organization
Organization Name:FIRST RESPONSE ORTHOPAEDIC GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-895-8890
Mailing Address - Street 1:2501 N ORANGE AVE
Mailing Address - Street 2:SUITE 340
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4603
Mailing Address - Country:US
Mailing Address - Phone:407-895-8890
Mailing Address - Fax:407-895-3608
Practice Address - Street 1:2501 N ORANGE AVE
Practice Address - Street 2:SUITE 340
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4603
Practice Address - Country:US
Practice Address - Phone:407-895-8890
Practice Address - Fax:407-895-3608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK6883Medicare ID - Type UnspecifiedMEDICARE GROUP