Provider Demographics
NPI:1689639783
Name:ORTHOPAEDIC CENTER OF SOUTHWEST FLORIDA, PLLC
Entity Type:Organization
Organization Name:ORTHOPAEDIC CENTER OF SOUTHWEST FLORIDA, PLLC
Other - Org Name:SFORZO DILLINGHAM STEWART ORTHOPEDICS AND SPORTS MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:R
Authorized Official - Last Name:SFORZO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-378-5100
Mailing Address - Street 1:5831 BEE RIDGE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-5090
Mailing Address - Country:US
Mailing Address - Phone:941-378-5100
Mailing Address - Fax:941-378-2805
Practice Address - Street 1:5831 BEE RIDGE RD STE 300
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-5090
Practice Address - Country:US
Practice Address - Phone:941-378-5100
Practice Address - Fax:941-378-2805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDE5040OtherRAILROAD MEDICARE
FL=========OtherTAX ID
5987330001Medicare NSC
FLK9608Medicare PIN