Provider Demographics
NPI:1649547084
Name:ORTHOPEDIC ASSOCIATES, PA
Entity type:Organization
Organization Name:ORTHOPEDIC ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:JEROME
Authorized Official - Middle Name:
Authorized Official - Last Name:GUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-459-1446
Mailing Address - Street 1:225 N ATLANTIC AVE
Mailing Address - Street 2:SUITE 603
Mailing Address - City:COCOA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32931-4315
Mailing Address - Country:US
Mailing Address - Phone:321-459-1446
Mailing Address - Fax:321-452-1261
Practice Address - Street 1:220 N SYKES CREEK PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-3489
Practice Address - Country:US
Practice Address - Phone:321-459-1446
Practice Address - Fax:321-452-1261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-30
Last Update Date:2015-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty