# ORTHO FLORIDA LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ORTHO FLORIDA. LLC
- **Other names:** Georgiy Brusovanik
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1649516717
- **Legal business name:** ORTHO FLORIDA. LLC
- **Authorized official:** JASON TOCCI (CEO)
- **Authorized official phone:** (954) 410-5194

## Contact information

- **Practice address:** 7150 W 20TH AVE, SUITE 209, HIALEAH, FL 33016-5529
- **Practice address phone:** (305) 467-5678
- **Practice address fax:** (305) 503-7006
- **Mailing address:** 660 GLADES RD, SUITE 460, BOCA RATON, FL 33431-6465
- **Mailing address phone:** (561) 300-1779

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | MDR-4545 | HI | Yes |

## Other

- **Enumeration date:** 12/18/2012
- **Last updated:** 12/18/2012