Organization
FLORIDA ORTHOPEDICS AND NEUROSURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL WYCOKI JR. (MANAGER)
(772) 467-2677
Entity
Organization
Contact information
Practice address
1855 SE PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34952-5530
(772) 467-2677
(772) 467-2621
Mailing address
4343 N US HIGHWAY 1, FORT PIERCE, FL 34946-6434
(772) 467-2677
(772) 467-2621
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
ME81066
FL
Other
Enumeration date
07/13/2017
Last updated
07/13/2017
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