Provider Demographics
NPI:1265873434
Name:HOLLYWOOD ORTHOPEDICS
Entity type:Organization
Organization Name:HOLLYWOOD ORTHOPEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SPENCER
Authorized Official - Middle Name:
Authorized Official - Last Name:HASTINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-279-2572
Mailing Address - Street 1:4801 S UNIVERSITY DR
Mailing Address - Street 2:265
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-3839
Mailing Address - Country:US
Mailing Address - Phone:954-279-2572
Mailing Address - Fax:855-299-5905
Practice Address - Street 1:6495 TAFT ST
Practice Address - Street 2:200
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-4110
Practice Address - Country:US
Practice Address - Phone:954-684-7678
Practice Address - Fax:855-299-5905
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASSOCIATES IN FAMILY PRACTICE OF BROWARD, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty