Organization
SOUTHEAST ORTHOPEDIC SPECIALISTS, INC
Active
Organization
SOUTHEAST ORTHOPEDIC SPECIALISTS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT PUCKETT (PRESIDENT)
(904) 634-0640
Entity
Organization
Contact information
Practice address
10475 CENTURION PKWY N, SUITE 220, JACKSONVILLE, FL 32256-5003
(904) 634-0640
(904) 634-0203
Mailing address
10475 CENTURION PKWY N STE 220, JACKSONVILLE, FL 32256-5004
(904) 634-0640
(904) 634-0203
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
ME80485
FL
Other
Enumeration date
12/23/2015
Last updated
09/29/2022
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