Organization
COASTALORTHOPEDIC CENTER, INC.
Active
Parent organization
COASTALORTHOPEDIC CENTER, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
COASTALORTHOPEDIC CENTER, INC.
Authorized official
JOSEPH PERRETTA C.P. (OWNER)
(772) 871-9200
Entity
Organization
Contact information
Practice address
710 NW PARK ST, OKEECHOBEE, FL 34972-4155
(863) 357-0079
(772) 336-4040
Mailing address
510 SW PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34953-1943
(772) 871-9200
(772) 336-4040
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
PRO84
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200996001
—
FL
Enumeration date
06/05/2013
Last updated
06/05/2013
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