Organization
THE CENTER FOR BONE AND JOINT DISEASE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE NICOLE MARTINO (BILLING DEPARTMENT)
(727) 857-4397
Entity
Organization
Contact information
Practice address
16506 POINTE VILLAGE DR STE 109, LUTZ, FL 33558-5255
(727) 605-3808
(352) 503-2361
Mailing address
7544 JACQUE RD, HUDSON, FL 34667-7162
(727) 697-2200
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
255796700
—
FL
01
—
38329
BCBS
FL
Enumeration date
01/09/2018
Last updated
01/09/2018
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