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Organization
ORTHO FLORIDA, LLC
Active
Organization
ORTHO FLORIDA, LLC
Active
Parent organization
ORTHO FLORIDA, LLC
Other names
360 Orthopedics
Organization subpart
Yes
Provider details
NPI number
Legal business name
ORTHO FLORIDA, LLC
Authorized official
DANE TRASK (OF CEO)
(813) 747-1128
Entity
Organization
Contact information
Practice address
5985 SILVER FALLS RUN, LAKEWOOD RANCH, FL 34211-1290
(941) 951-2663
Mailing address
433 PLAZA REAL STE 275, BOCA RATON, FL 33432-3999
(561) 300-1792
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
NULL
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
NULL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
NULL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
213E00000X
Podiatrist
—
NULL
213E00000X
Podiatrist
—
—
Other
Enumeration date
04/13/2022
Last updated
04/13/2022
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