Organization
JUPITER ORTHOPEDICS AND SPORTS MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WADE C VAN SICE MD (PHYSICIAN/SURGEON)
(504) 615-6325
Entity
Organization
Contact information
Practice address
2055 MILITARY TRL, SUITE 204, JUPITER, FL 33458-7801
(561) 744-9733
Mailing address
2055 MILITARY TRL, SUITE 204, JUPITER, FL 33458-7801
(561) 744-9733
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
ME122314
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1500356
—
LA
Enumeration date
12/08/2014
Last updated
12/08/2014
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