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Organization
SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC
Active
Organization
SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT PUCKETT (VP)
(904) 394-1282
Entity
Organization
Contact information
Practice address
4565 US HIGHWAY 17 STE 200, FLEMING ISLAND, FL 32003-4823
(904) 634-0640
(904) 634-0203
Mailing address
6800 SOUTHPOINT PKWY STE 300, JACKSONVILLE, FL 32216-8203
(904) 394-1282
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
NULL
174400000X
Specialist
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
09/27/2018
Last updated
12/12/2022
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