# THE CENTER FOR BONE AND JOINT DISEASE, PA

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

## Provider details

- **NPI number:** 1811404155
- **Authorized official:** GRACE NICOLE MARTINO (BILLING DEPARTMENT)
- **Authorized official phone:** (727) 857-4397

## Contact information

- **Practice address:** 16506 POINTE VILLAGE DR STE 109, LUTZ, FL 33558-5255
- **Practice address phone:** (727) 605-3808
- **Practice address fax:** (352) 503-2361
- **Mailing address:** 7544 JACQUE RD, HUDSON, FL 34667-7162
- **Mailing address phone:** (727) 697-2200

## Taxonomy

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

## Other

- **Enumeration date:** 01/09/2018
- **Last updated:** 01/09/2018