Provider Demographics
NPI:1851451785
Name:ORTHOPAEDIC AND TRAUMA CENTER
Entity Type:Organization
Organization Name:ORTHOPAEDIC AND TRAUMA CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:H
Authorized Official - Last Name:ZUERNDORFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-724-6300
Mailing Address - Street 1:2924 BETHANY PL
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-1401
Mailing Address - Country:US
Mailing Address - Phone:727-726-1127
Mailing Address - Fax:
Practice Address - Street 1:1831 N BELCHER RD
Practice Address - Street 2:STE G-2B
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-1449
Practice Address - Country:US
Practice Address - Phone:727-724-6300
Practice Address - Fax:727-724-6330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME55438207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic TraumaGroup - Single Specialty