Provider Demographics
NPI:1639615180
Name:ORTHO FLORIDA, LLC
Entity Type:Organization
Organization Name:ORTHO FLORIDA, LLC
Other - Org Name:FLORIDA BONE AND JOINT SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:DANE
Authorized Official - Middle Name:
Authorized Official - Last Name:TRASK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-787-1128
Mailing Address - Street 1:751 PARK OF COMMERCE DR
Mailing Address - Street 2:STE 112
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-3626
Mailing Address - Country:US
Mailing Address - Phone:561-300-1792
Mailing Address - Fax:
Practice Address - Street 1:1040 GULF BREEZE PKWY
Practice Address - Street 2:STE 200
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32561-7809
Practice Address - Country:US
Practice Address - Phone:850-916-3700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHO FLORIDA, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-09
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty