Organization
CITRUS ORTHOPAEDIC AND JOINT INSTITUTE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW J PETRELLA MD (OWNER)
(352) 746-2663
Entity
Organization
Contact information
Practice address
950 N AVALON WAY, LECANTO, FL 34461-6004
(352) 746-2663
(352) 746-6907
Mailing address
PO BOX 1990, CRYSTAL RIVER, FL 34423-1990
(352) 746-2663
(352) 746-6907
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME0074278
FL
207XS0117X
Orthopaedic Surgery of the Spine Physician
ME0080012
FL
213E00000X
Podiatrist
PO0002716
FL
225100000X
Physical Therapist
PT20489
FL
225100000X
Physical Therapist
PT8397
FL
225X00000X
Occupational Therapist
OT3425
FL
363A00000X
Physician Assistant
PA9108675
FL
363AM0700X
Medical Physician Assistant
PA3291
FL
363AM0700X
Medical Physician Assistant
PA9101478
FL
363AS0400X
Surgical Physician Assistant
PA3291
FL
363AS0400X
Surgical Physician Assistant
PA9101478
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273441900
—
FL
01
—
94997
BCBS FLA
FL
01
—
DA2404
RAILROAD MEDICARE
FL
Enumeration date
02/22/2007
Last updated
04/27/2015
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