Provider Demographics
NPI:1689756835
Name:ORTHOPEDIC CENTER OF PALM BEACH COUNTY, INC.
Entity Type:Organization
Organization Name:ORTHOPEDIC CENTER OF PALM BEACH COUNTY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:HORNBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-967-6500
Mailing Address - Street 1:180 JFK DR
Mailing Address - Street 2:STE 100
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462-6641
Mailing Address - Country:US
Mailing Address - Phone:561-967-6500
Mailing Address - Fax:561-433-4175
Practice Address - Street 1:6056 BOYNTON BEACH BLVD
Practice Address - Street 2:SUITE 215
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3584
Practice Address - Country:US
Practice Address - Phone:561-967-6500
Practice Address - Fax:561-433-4175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL036093700Medicaid
FL00840Medicare PIN
FL4945950003Medicare NSC