Provider Demographics
NPI:1376739706
Name:SANFORD ORTHOPEDIC & REHABILITATION
Entity type:Organization
Organization Name:SANFORD ORTHOPEDIC & REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-321-7500
Mailing Address - Street 1:441 E AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32773-5494
Mailing Address - Country:US
Mailing Address - Phone:407-321-7500
Mailing Address - Fax:407-302-1440
Practice Address - Street 1:441 E AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32773-5494
Practice Address - Country:US
Practice Address - Phone:407-321-7500
Practice Address - Fax:407-302-1440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME17784174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty