Provider Demographics
NPI:1952662355
Name:SCOLIOSIS & PEDIATRIC ORTHO PA
Entity Type:Organization
Organization Name:SCOLIOSIS & PEDIATRIC ORTHO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:ROMANO
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:954-321-7762
Mailing Address - Street 1:6370 N STATE ROAD 7
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-3606
Mailing Address - Country:US
Mailing Address - Phone:954-321-7762
Mailing Address - Fax:954-321-9596
Practice Address - Street 1:6370 N STATE ROAD 7
Practice Address - Street 2:SUITE 100
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-3606
Practice Address - Country:US
Practice Address - Phone:954-321-7762
Practice Address - Fax:954-321-9596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-01
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME62835207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic SurgeryGroup - Single Specialty