Organization
ACTIVE ORTHOPEDICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WENDELL BULMER MD (PRESIDENT)
(727) 538-8865
Entity
Organization
Contact information
Practice address
775 COUNTY ROAD 1, PALM HARBOR, FL 34683-6306
(727) 538-8865
(727) 539-8726
Mailing address
755 COUNTY ROAD 1, PALM HARBOR, FL 34683-6306
(813) 864-3998
(813) 864-3141
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OS7010
MEDICAL LICENSE
FL
Enumeration date
10/04/2011
Last updated
01/09/2012
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