Organization
FLORIDA SPORTS MEDICINE INSTITUTE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KAREN LYNN HASELTINE (CEO)
(904) 823-3764
Entity
Organization
Contact information
Practice address
4131 UNIVERSITY BLVD S, SUITE 15, JACKSONVILLE, FL 32216-4326
(904) 854-4587
(904) 429-0318
Mailing address
150 SOUTHPARK BLVD, SUITE 102, ST AUGUSTINE, FL 32086-5190
(904) 823-3764
(904) 429-0318
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
OS7217
FL
Other
Enumeration date
02/28/2008
Last updated
01/06/2010
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