Provider Demographics
NPI:1285881839
Name:FLORIDA ORTHOPEDIC SYSTEMS
Entity type:Organization
Organization Name:FLORIDA ORTHOPEDIC SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-765-5689
Mailing Address - Street 1:10434 FLY FISHING ST
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-2734
Mailing Address - Country:US
Mailing Address - Phone:813-765-5689
Mailing Address - Fax:
Practice Address - Street 1:10434 FLY FISHING ST
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-2734
Practice Address - Country:US
Practice Address - Phone:813-765-5689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies