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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 (CEO)
(813) 747-1128
Entity
Organization

Contact information

Practice address
5504 PINEBROOK RD STE 201, NOKOMIS, FL 34275-3745
(941) 951-2663
Mailing address
660 GLADES RD STE 460, BOCA RATON, FL 33431-6469
(561) 300-1792

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
207XS0106X
Orthopaedic Hand Surgery Physician
207XS0117X
Orthopaedic Surgery of the Spine Physician
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician

Other

Enumeration date
04/05/2023
Last updated
04/05/2023
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