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Organization

ORTHO FLORIDA, LLC

Active
Parent organization
ORTHO FLORIDA, LLC
Other names
360 Orthopedics
Organization subpart
Yes

Provider details

NPI number
Legal business name
ORTHO FLORIDA, LLC
Authorized official
DANE TRASK (OF CEO)
(813) 747-1128
Entity
Organization

Contact information

Practice address
2750 BAHIA VISTA ST STE 100, SARASOTA, FL 34239-2640
(941) 951-2663
Mailing address
433 PLAZA REAL STE 275, BOCA RATON, FL 33432-3999
(813) 747-1128

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
207XS0106X
Orthopaedic Hand Surgery Physician
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
213E00000X
Podiatrist

Other

Enumeration date
04/13/2022
Last updated
04/13/2022
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