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Organization
SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC
Active
Organization
SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT PUCKETT (PRESIDENT)
(904) 634-0640
Entity
Organization
Contact information
Practice address
216 SOUTHPARK CIR E STE 216, ST AUGUSTINE, FL 32086-5135
(904) 634-0203
Mailing address
6800 SOUTHPOINT PKWY STE 300, JACKSONVILLE, FL 32216-8203
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
03/15/2023
Last updated
03/15/2023
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