# FLORIDA KEYS ORTHOPEDIC AND SPORTS MEDICINE CENTER INC

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

## Provider details

- **NPI number:** 1760430987
- **Authorized official:** PAUL S ELLISON JR. MD (PRESIDENT)
- **Authorized official phone:** (305) 453-3633

## Contact information

- **Practice address:** 100210 OVERSEAS HWY, STE 3, KEY LARGO, FL 33037-2527
- **Practice address phone:** (305) 453-3633
- **Practice address fax:** (305) 453-3637
- **Mailing address:** 100210 OVERSEAS HWY, STE 3, KEY LARGO, FL 33037-2527
- **Mailing address phone:** (305) 453-3633
- **Mailing address fax:** (305) 453-3637

## Taxonomy

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

## Other

- **Enumeration date:** 05/04/2006
- **Last updated:** 03/01/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 379646900 | — | FL |