Provider Demographics
NPI:1770290108
Name:DYNAMIC ORTHOPEDIC CENTERS
Entity type:Organization
Organization Name:DYNAMIC ORTHOPEDIC CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-482-3501
Mailing Address - Street 1:4846 NW 103RD WAY
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-1723
Mailing Address - Country:US
Mailing Address - Phone:954-482-3501
Mailing Address - Fax:
Practice Address - Street 1:2929 N UNIVERSITY DR STE 200
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-1424
Practice Address - Country:US
Practice Address - Phone:954-482-3501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center