# ORTHO FLORIDA LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ORTHO FLORIDA LLC
- **Other names:** Sports Ortho LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1689949224
- **Legal business name:** ORTHO FLORIDA LLC
- **Authorized official:** SHATINA CANNON (MANAGER)
- **Authorized official phone:** (561) 826-2000

## Contact information

- **Practice address:** 3880 COCONUT CREEK PKWY, SUITE 303, COCONUT CREEK, FL 33066-1652
- **Practice address phone:** (561) 826-2000
- **Practice address fax:** (561) 826-2600
- **Mailing address:** 9325 GLADES RD, SUITE 205, BOCA RATON, FL 33434-3988
- **Mailing address phone:** (561) 826-2000
- **Mailing address fax:** (561) 826-2600

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | NULL | — |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/15/2012
- **Last updated:** 09/06/2013