Provider Demographics
NPI:1497795884
Name:COMMUNITY ORTHOPEDICS & HAND SURGERY, LLC
Entity Type:Organization
Organization Name:COMMUNITY ORTHOPEDICS & HAND SURGERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-724-3400
Mailing Address - Street 1:7421 N UNIVERSITY DR
Mailing Address - Street 2:#107
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2977
Mailing Address - Country:US
Mailing Address - Phone:954-724-3400
Mailing Address - Fax:
Practice Address - Street 1:7421 N UNIVERSITY DR
Practice Address - Street 2:#107
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2977
Practice Address - Country:US
Practice Address - Phone:954-724-3400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL34545OtherBLUE CROSS/ BLUE SHEILD O
FLK4111Medicare PIN
FL34545OtherBLUE CROSS/ BLUE SHEILD O