# BLUE DIAMOND ORTHOPEDIC, LLC

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

## Provider details

- **NPI number:** 1568942431
- **Authorized official:** DAVID HENDRICKS CPO (PRESIDENT)
- **Authorized official phone:** (407) 613-2001

## Contact information

- **Practice address:** 6439 MILNER BLVD STE 4, ORLANDO, FL 32809-6692
- **Practice address phone:** (407) 613-2001
- **Practice address fax:** (407) 613-2010
- **Mailing address:** 6439 MILNER BLVD STE 4, ORLANDO, FL 32809-6692
- **Mailing address phone:** (407) 613-2001
- **Mailing address fax:** (407) 613-2010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 08/20/2018
- **Last updated:** 08/20/2018