Provider Demographics
NPI:1205805165
Name:ORTHOPAEDIC CENTER OF OKEECHOBEE, PA
Entity type:Organization
Organization Name:ORTHOPAEDIC CENTER OF OKEECHOBEE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANGER
Authorized Official - Prefix:MS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:F
Authorized Official - Last Name:STRIEBEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-763-8100
Mailing Address - Street 1:1920 HIGHWAY 441 N
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34972-1922
Mailing Address - Country:US
Mailing Address - Phone:863-763-8100
Mailing Address - Fax:863-763-8669
Practice Address - Street 1:1920 HIGHWAY 441 N
Practice Address - Street 2:
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34972-1922
Practice Address - Country:US
Practice Address - Phone:863-763-8100
Practice Address - Fax:863-763-8669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 0064131207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME 0064131OtherMEDICAL LICENSE NUMBER
FLF64708Medicare UPIN
FLME 0064131OtherMEDICAL LICENSE NUMBER
0931220001Medicare NSC
FL200025047Medicare PIN
1720016868Medicare NSC