Provider Demographics
NPI:1013464858
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:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
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 1:9325 GLADES RD STE 205
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-3988
Practice Address - Country:US
Practice Address - Phone:561-314-7200
Practice Address - Fax:561-314-7201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-09
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4945950005Medicare NSC
FL00840Medicare UPIN