Organization
ORTHOPEDIC CENTER OF FLORIDA, INC
Active
Other names
Sports Medicine and Joint Replacement Specialist
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK FARMER (VP)
(239) 482-2663
Entity
Organization
Contact information
Practice address
12670 CREEKSIDE LANE, SUITE 202, FORT MYERS, FL 33919-8759
(239) 482-2663
(239) 482-7585
Mailing address
12670 CREEKSIDE LANE, SUITE 202, FORT MYERS, FL 33919-8759
(239) 482-2663
(239) 482-7585
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00231
GROUP BCBS OF FLORIDA
FL
01
—
0670070001
MEDICARE DME
FL
05
—
265840200
—
FL
01
—
K0865
MEDICARE GROUP
FL
Enumeration date
07/11/2006
Last updated
12/30/2022
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