Organization
SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT PUCKETT (PRESIDENT)
(904) 634-0640
Entity
Organization
Contact information
Practice address
4565 US HIGHWAY 17 STE 200, FLEMING ISLAND, FL 32003-4823
(904) 634-0640
Mailing address
6800 SOUTHPOINT PKWY, JACKSONVILLE, FL 32216-6257
(904) 634-0640
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
09/28/2022
Last updated
12/12/2022
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