# FLORIDA MUSCULOSKELETAL SURGICAL GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ORTHOCARE Florida
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073850160
- **Authorized official:** YOLANDA SPENCER (CREDENTIALING MANAGER)
- **Authorized official phone:** (727) 456-4873

## Contact information

- **Practice address:** 4600 4TH ST N, ST PETERSBURG, FL 33703-3802
- **Practice address phone:** (727) 527-5272
- **Practice address fax:** (727) 522-7412
- **Mailing address:** 4600 4TH ST N, ST PETERSBURG, FL 33703-3802
- **Mailing address phone:** (727) 527-5272
- **Mailing address fax:** (727) 522-7412

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 6735700001 | FL | — |

## Other

- **Enumeration date:** 01/09/2013
- **Last updated:** 02/05/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 003UZ | BCBS | FL |
| 05 | — | 007968900 | — | FL |
| 01 | — | 6735700001 | MEDICARE DME PTAN | FL |