Provider Demographics
NPI:1871014258
Name:ORTHO FLORIDA, LLC
Entity Type:Organization
Organization Name:ORTHO FLORIDA, LLC
Other - Org Name:MICHELE DAPUZZO MD, PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
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 STE 112
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-3622
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7000 SW 62ND AVE STE 600
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4728
Practice Address - Country:US
Practice Address - Phone:305-917-0777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHO FLORIDA, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-06
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryGroup - Multi-Specialty