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Organization

ORTHO FLORIDA LLC

Active
Parent organization
ORTHO FLORIDA LLC
Other names
Sports Ortho LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
ORTHO FLORIDA LLC
Authorized official
SHATINA CANNON (MANAGER)
(561) 826-2000
Entity
Organization

Contact information

Practice address
3880 COCONUT CREEK PKWY, SUITE 303, COCONUT CREEK, FL 33066-1652
(561) 826-2000
(561) 826-2600
Mailing address
9325 GLADES RD, SUITE 205, BOCA RATON, FL 33434-3988
(561) 826-2000
(561) 826-2600

Taxonomy

Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
207X00000X
Orthopaedic Surgery Physician
Primary

Other

Enumeration date
03/15/2012
Last updated
09/06/2013
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