Provider Demographics
NPI:1558317545
Name:TOTAL ORTHOPAEDIC CARE PA
Entity Type:Organization
Organization Name:TOTAL ORTHOPAEDIC CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BILODEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-735-3535
Mailing Address - Street 1:4850 W OAKLAND PARK BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33313-7260
Mailing Address - Country:US
Mailing Address - Phone:954-735-3535
Mailing Address - Fax:954-484-7000
Practice Address - Street 1:4850 W OAKLAND PARK BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33313-7260
Practice Address - Country:US
Practice Address - Phone:954-735-3535
Practice Address - Fax:954-484-7000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL72954Medicare ID - Type Unspecified