Organization
ORTHOPAEDIC ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANGELA GRIESE (SOFTWARE SUPPORT/CONTRACT MANAGER)
(850) 863-2153
Entity
Organization
Contact information
Practice address
1034 MAR WALT DR UNIT 100, FORT WALTON BEACH, FL 32547-6637
(850) 863-2153
(850) 315-9350
Mailing address
PO BOX 740923, ATLANTA, GA 30374-0923
(850) 863-2153
(850) 315-9350
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002879600
—
FL
01
—
1467589010
MEDICARE NPI
FL
05
—
1467589010
—
FL
01
—
DC690A
MEDICARE GROUP PIN
FL
Enumeration date
02/28/2007
Last updated
07/20/2022
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