Provider Demographics
NPI:1841289576
Name:ORTHOPEDIC SPECIALISTS OF S FLORIDA P A
Entity type:Organization
Organization Name:ORTHOPEDIC SPECIALISTS OF S FLORIDA P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ORESTES
Authorized Official - Middle Name:G
Authorized Official - Last Name:ROSABAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-822-0401
Mailing Address - Street 1:7100 W 20TH AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1897
Mailing Address - Country:US
Mailing Address - Phone:305-822-0401
Mailing Address - Fax:305-824-1748
Practice Address - Street 1:7100 W 20TH AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1897
Practice Address - Country:US
Practice Address - Phone:305-822-0401
Practice Address - Fax:305-824-1748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-15
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
98120OtherGROUP MEDICARE ID NUMBER