Provider Demographics
NPI:1437659869
Name:ORTHOPAEDIC CENTER OF S FLORIDA
Entity Type:Organization
Organization Name:ORTHOPAEDIC CENTER OF S FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:JOSSLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORAZAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-473-6344
Mailing Address - Street 1:600 S PINE ISLAND RD STE 300
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3179
Mailing Address - Country:US
Mailing Address - Phone:954-473-6344
Mailing Address - Fax:954-473-8119
Practice Address - Street 1:7171 N UNIVERSITY DR STE 100
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2902
Practice Address - Country:US
Practice Address - Phone:954-473-6344
Practice Address - Fax:954-473-8119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty