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
216 SOUTHPARK CIR E, ST AUGUSTINE, FL 32086-5135
(904) 634-0640
Mailing address
6800 SOUTHPOINT PKWY STE 200, JACKSONVILLE, FL 32216-6221
(904) 634-0640
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
09/29/2022
Last updated
09/29/2022
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