Provider Demographics
NPI:1457171191
Name:ORTHOCARE EXPRESS LLC
Entity type:Organization
Organization Name:ORTHOCARE EXPRESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GUILHERME
Authorized Official - Middle Name:
Authorized Official - Last Name:GUISTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:507-884-9439
Mailing Address - Street 1:1835 EASTWEST PKWY STE 19
Mailing Address - Street 2:
Mailing Address - City:FLEMING ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32003-5311
Mailing Address - Country:US
Mailing Address - Phone:507-884-9439
Mailing Address - Fax:507-261-8869
Practice Address - Street 1:1835 EASTWEST PKWY STE 19
Practice Address - Street 2:
Practice Address - City:FLEMING ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32003-5311
Practice Address - Country:US
Practice Address - Phone:507-884-9439
Practice Address - Fax:507-261-8869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty