Organization
THE ORTHOPAEDIC INSTITUTE, PA
Active
Parent organization
THE ORTHOPAEDIC INSTITUTE, PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE ORTHOPAEDIC INSTITUTE, PA
Authorized official
JOLIE HERREN (CREDENTIALING MANAGER)
(352) 336-6000
Entity
Organization
Contact information
Practice address
17270 SE 109TH TERRACE RD, SUMMERFIELD, FL 34491-9015
(352) 336-6000
Mailing address
4500 NEWBERRY RD, GAINESVILLE, FL 32607-2245
(352) 336-6000
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Enumeration date
10/16/2019
Last updated
05/04/2022
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