Organization
ORTHO FLORIDA LLC
Active
Other names
Ft Lauderdale Ortho and Sports Medicine, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANE TRASK (CEO)
(813) 787-1128
Entity
Organization
Contact information
Practice address
1414 SE 3RD AVE, FORT LAUDERDALE, FL 33316-1910
(954) 764-8033
(954) 764-5522
Mailing address
1414 SE 3RD AVE, FORT LAUDERDALE, FL 33316-1910
(954) 764-8033
(954) 764-5522
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
375852400
—
FL
01
—
CN7775
RAILROAD MEDICARE
FL
Enumeration date
09/12/2005
Last updated
01/20/2016
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