Organization
INSTITUTE OF REGENERATIVE ORTHOPEDICS AND SPORTS MEDICINE LLC
Active
Organization
INSTITUTE OF REGENERATIVE ORTHOPEDICS AND SPORTS MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORGE ANTONIO GONZALEZ MD (OWNER)
(786) 566-0338
Entity
Organization
Contact information
Practice address
3333 W COMMERCIAL BLVD STE 101, FORT LAUDERDALE, FL 33309-3424
(786) 566-0338
Mailing address
1441 NE 54TH ST, FORT LAUDERDALE, FL 33334-4932
Taxonomy
Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017619600
—
FL
Enumeration date
03/30/2021
Last updated
02/21/2022
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