# THE ORTHOPAEDIC INSTITUTE, PA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** THE ORTHOPAEDIC INSTITUTE, PA
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1629610118
- **Legal business name:** THE ORTHOPAEDIC INSTITUTE, PA
- **Authorized official:** JOLIE HERREN (CREDENTIALING MANAGER)
- **Authorized official phone:** (352) 336-6000

## Contact information

- **Practice address:** 17270 SE 109TH TERRACE RD, SUMMERFIELD, FL 34491-9015
- **Practice address phone:** (352) 336-6000
- **Mailing address:** 4500 NEWBERRY RD, GAINESVILLE, FL 32607-2245
- **Mailing address phone:** (352) 336-6000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | NULL | — |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | — | — |
| 207XX0004X | Orthopaedic Foot and Ankle Surgery Physician | — | NULL | — |
| 207XX0004X | Orthopaedic Foot and Ankle Surgery Physician | — | — | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | NULL | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | — | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | — |

## Other

- **Enumeration date:** 10/16/2019
- **Last updated:** 05/04/2022