# ORTHOPAEDIC SPECIALISTS OF MIAMI, PLLC

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

## Provider details

- **NPI number:** 1679970941
- **Authorized official:** MR. VICTOR TILLER (REGIONAL DIRECTOR OF MANAGED CARE)
- **Authorized official phone:** (615) 332-1439

## Contact information

- **Practice address:** 4730 N HABANA AVE, SUITE 104, TAMPA, FL 33614-7163
- **Practice address phone:** (813) 872-4492
- **Mailing address:** 4730 N HABANA AVE, SUITE 104, TAMPA, FL 33614-7163
- **Mailing address phone:** (813) 872-4492

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | OS12597 | FL | Yes |

## Other

- **Enumeration date:** 12/02/2014
- **Last updated:** 12/02/2014