Provider Demographics
NPI:1124650122
Name:ASCEND ORTHOPAEDICS AND SPORTS MEDICINE P.A.
Entity type:Organization
Organization Name:ASCEND ORTHOPAEDICS AND SPORTS MEDICINE P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMUN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAKANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MBA
Authorized Official - Phone:304-668-0051
Mailing Address - Street 1:5119 5TH WAY N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703-2933
Mailing Address - Country:US
Mailing Address - Phone:304-668-0051
Mailing Address - Fax:
Practice Address - Street 1:6450 38TH AVE N STE 320
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-1649
Practice Address - Country:US
Practice Address - Phone:727-520-0190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty