# ORTHONOW WESTON

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

## Provider details

- **NPI number:** 1508269572
- **Authorized official:** ASHLEY BOLANOS (ADMINISTRATOR)
- **Authorized official phone:** (954) 802-6763

## Contact information

- **Practice address:** 4825 SW 148TH AVE, SOUTHWEST RANCHES, FL 33330-2129
- **Practice address phone:** (954) 802-6763
- **Mailing address:** 4825 SW 148TH AVE, SOUTHWEST RANCHES, FL 33330-2129
- **Mailing address phone:** (954) 802-6763

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PS0010X | Sports Medicine (Emergency Medicine) Physician | HCC10353 | FL | Yes |

## Other

- **Enumeration date:** 10/03/2014
- **Last updated:** 10/03/2014