# SPORTS MEDICINE ASSOCIATES OF SOUTH FLORIDA, P.A.

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

## Provider details

- **NPI number:** 1487624771
- **Authorized official:** CHRYSTAL A. HERRERA (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (305) 218-6965

## Contact information

- **Practice address:** 220 SW 84TH AVE STE 102, PLANTATION, FL 33324-2729
- **Practice address phone:** (954) 720-1530
- **Practice address fax:** (954) 720-6540
- **Mailing address:** 220 SW 84TH AVE STE 102, PLANTATION, FL 33324-2729
- **Mailing address phone:** (954) 349-2345
- **Mailing address fax:** (954) 641-1086

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | NULL | — |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | — | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | NULL | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 01/26/2006
- **Last updated:** 09/24/2024