Provider Demographics
NPI:1205537099
Name:ROYAL PALM ORTHOPEDICS SPORTS MEDICINE AND INSTITUTE
Entity type:Organization
Organization Name:ROYAL PALM ORTHOPEDICS SPORTS MEDICINE AND INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:U
Authorized Official - Last Name:ARANGO
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:863-324-6100
Mailing Address - Street 1:23781 US HIGHWAY 27 # 122
Mailing Address - Street 2:
Mailing Address - City:LAKE WALES
Mailing Address - State:FL
Mailing Address - Zip Code:33859-7802
Mailing Address - Country:US
Mailing Address - Phone:863-324-6100
Mailing Address - Fax:863-679-9182
Practice Address - Street 1:5401 W KENNEDY BLVD STE 100
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-2457
Practice Address - Country:US
Practice Address - Phone:863-324-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty