# JEWETT ORTHOPAEDIC CLINIC LLC

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

## Provider details

- **NPI number:** 1821097437
- **Authorized official:** DR. MICHAEL V JABLONSKI M.D. (C.E.O.)
- **Authorized official phone:** (407) 647-2287

## Contact information

- **Practice address:** 1285 ORANGE AVE, WINTER PARK, FL 32789-4949
- **Practice address phone:** (407) 647-2287
- **Practice address fax:** (407) 643-1300
- **Mailing address:** 1285 ORANGE AVE, WINTER PARK, FL 32789-4949
- **Mailing address phone:** (407) 647-2287
- **Mailing address fax:** (407) 643-1300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | FL | Yes |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | FL | — |
| 207XS0114X | Adult Reconstructive Orthopaedic Surgery Physician | — | FL | — |
| 207XS0117X | Orthopaedic Surgery of the Spine Physician | — | FL | — |
| 207XX0004X | Orthopaedic Foot and Ankle Surgery Physician | — | FL | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | FL | — |
| 207XX0801X | Orthopaedic Trauma Physician | — | FL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | FL | — |
| 2085B0100X | Body Imaging Physician | — | FL | — |
| 2085N0700X | Neuroradiology Physician | — | FL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | FL | — |
| 2471B0102X | Bone Densitometry Radiologic Technologist | — | FL | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | FL | — |
| 335E00000X | Prosthetic/Orthotic Supplier | — | FL | — |

## Other

- **Enumeration date:** 07/15/2005
- **Last updated:** 01/14/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 060759200 | — | FL |