Provider Demographics
NPI:1306435904
Name:ORTHOPAEDIC DEVELOPMENT PARTNERS LLC
Entity type:Organization
Organization Name:ORTHOPAEDIC DEVELOPMENT PARTNERS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDSMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-535-6647
Mailing Address - Street 1:13837 CIRCA CROSSING DR STE 100
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-4383
Mailing Address - Country:US
Mailing Address - Phone:813-535-6647
Mailing Address - Fax:
Practice Address - Street 1:13837 CIRCA CROSSING DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:LITHIA
Practice Address - State:FL
Practice Address - Zip Code:33547
Practice Address - Country:US
Practice Address - Phone:813-280-0970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-18
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical