# ACTIVE ORTHOPEDICS, LLC

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

## Provider details

- **NPI number:** 1952685356
- **Authorized official:** DR. WENDELL BULMER MD (PRESIDENT)
- **Authorized official phone:** (727) 538-8865

## Contact information

- **Practice address:** 775 COUNTY ROAD 1, PALM HARBOR, FL 34683-6306
- **Practice address phone:** (727) 538-8865
- **Practice address fax:** (727) 539-8726
- **Mailing address:** 755 COUNTY ROAD 1, PALM HARBOR, FL 34683-6306
- **Mailing address phone:** (813) 864-3998
- **Mailing address fax:** (813) 864-3141

## Taxonomy

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

## Other

- **Enumeration date:** 10/04/2011
- **Last updated:** 01/09/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | OS7010 | MEDICAL LICENSE | FL |