Organization
SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT CHRISTOPHER PUCKETT MD (AUTHORIZED OFFICIAL)
(904) 634-0640
Entity
Organization
Contact information
Practice address
232 PONTE VEDRA PARK DR, PONTE VEDRA, FL 32082-6600
(904) 634-0640
(904) 634-0203
Mailing address
6800 SOUTHPOINT PKWY STE 300, JACKSONVILLE, FL 32216-8203
(904) 634-0640
(904) 634-0203
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
ME80485
FL
Other
Enumeration date
12/30/2015
Last updated
12/12/2022
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