# STAR ORTHOPEDICS AND SPINE OF FORT MYERS LLC

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

## Provider details

- **NPI number:** 1669283495
- **Authorized official:** HILLARY KOERNER (COO)
- **Authorized official phone:** (561) 699-6373

## Contact information

- **Practice address:** 12610 WORLD PLAZA LN UNIT 61-2, FORT MYERS, FL 33907-4076
- **Practice address phone:** (561) 699-6373
- **Mailing address:** 1020 W OAK ST, KISSIMMEE, FL 34741-4113

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 01/20/2025
- **Last updated:** 01/20/2025