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Organization

SPINE & SPORTSMEDICINE SPECIALISTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL JEROME LORD M.D. (PRESIDENT)
(904) 687-4224
Entity
Organization

Contact information

Practice address
17327 BALLMONT PARK DR, ODESSA, FL 33556-6209
(904) 687-4224
(813) 852-2137
Mailing address
17327 BALLMONT PARK DR, ODESSA, FL 33556-6209
(904) 687-4224
(813) 852-2137

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary

Other

Enumeration date
03/16/2007
Last updated
11/13/2012
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