# CITRUS ORTHOPAEDIC AND JOINT INSTITUTE, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275668063
- **Authorized official:** DR. ANDREW J PETRELLA MD (OWNER)
- **Authorized official phone:** (352) 746-2663

## Contact information

- **Practice address:** 950 N AVALON WAY, LECANTO, FL 34461-6004
- **Practice address phone:** (352) 746-2663
- **Practice address fax:** (352) 746-6907
- **Mailing address:** PO BOX 1990, CRYSTAL RIVER, FL 34423-1990
- **Mailing address phone:** (352) 746-2663
- **Mailing address fax:** (352) 746-6907

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | ME0074278 | FL | Yes |
| 207XS0117X | Orthopaedic Surgery of the Spine Physician | ME0080012 | FL | — |
| 213E00000X | Podiatrist | PO0002716 | FL | — |
| 225100000X | Physical Therapist | PT20489 | FL | — |
| 225100000X | Physical Therapist | PT8397 | FL | — |
| 225X00000X | Occupational Therapist | OT3425 | FL | — |
| 363A00000X | Physician Assistant | PA9108675 | FL | — |
| 363AM0700X | Medical Physician Assistant | PA3291 | FL | — |
| 363AM0700X | Medical Physician Assistant | PA9101478 | FL | — |
| 363AS0400X | Surgical Physician Assistant | PA3291 | FL | — |
| 363AS0400X | Surgical Physician Assistant | PA9101478 | FL | — |

## Other

- **Enumeration date:** 02/22/2007
- **Last updated:** 04/27/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 273441900 | — | FL |
| 01 | — | 94997 | BCBS FLA | FL |
| 01 | — | DA2404 | RAILROAD MEDICARE | FL |