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Organization

FLORIDA MUSCULOSKELETAL SURGICAL GROUP LLC

Active
Other names
ORTHOCARE Florida
Organization subpart
No

Provider details

NPI number
Authorized official
YOLANDA SPENCER (CREDENTIALING MANAGER)
(727) 456-4873
Entity
Organization

Contact information

Practice address
4600 4TH ST N, ST PETERSBURG, FL 33703-3802
(727) 527-5272
(727) 522-7412
Mailing address
4600 4TH ST N, ST PETERSBURG, FL 33703-3802
(727) 527-5272
(727) 522-7412

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
332B00000X
Durable Medical Equipment & Medical Supplies
6735700001
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
003UZ
BCBS
FL
05
007968900
FL
01
6735700001
MEDICARE DME PTAN
FL
Enumeration date
01/09/2013
Last updated
02/05/2020
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