# FORT PIERCE ORTHOPAEDICS LLC

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

## Provider details

- **NPI number:** 1639246234
- **Authorized official:** MICKEY PICKLER (VP)
- **Authorized official phone:** (850) 523-2117

## Contact information

- **Practice address:** 1801 S 23RD ST, SUITES 7 AND 8, FORT PIERCE, FL 34950-4830
- **Practice address phone:** (772) 465-4651
- **Mailing address:** 1801 S 23RD ST, SUITES 7 AND 8, FORT PIERCE, FL 34950-4830
- **Mailing address phone:** (772) 465-4651

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/29/2006
- **Last updated:** 09/11/2007