Provider Demographics
NPI:1760402168
Name:ORNSTEIN, BRUCE CURTIS (DPM)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:CURTIS
Last Name:ORNSTEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 358870
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32635-8870
Mailing Address - Country:US
Mailing Address - Phone:386-362-2555
Mailing Address - Fax:386-362-2557
Practice Address - Street 1:609 5TH STREET SW
Practice Address - Street 2:SUITE 4
Practice Address - City:LIVE OAK
Practice Address - State:FL
Practice Address - Zip Code:32064-2239
Practice Address - Country:US
Practice Address - Phone:386-362-2555
Practice Address - Fax:352-362-2557
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2359213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL65351ZOtherMEDICARE
FL390209900Medicaid
P00693759OtherRAILROAD MEDICARE
FL65351Medicare ID - Type Unspecified
FL65351ZOtherMEDICARE