Provider Demographics
NPI:1770445314
Name:TALLAHASSEE ORTHOPEDIC CLINIC III, P.L.
Entity type:Organization
Organization Name:TALLAHASSEE ORTHOPEDIC CLINIC III, P.L.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-579-2733
Mailing Address - Street 1:5901 E FOWLER AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-2305
Mailing Address - Country:US
Mailing Address - Phone:813-978-9700
Mailing Address - Fax:
Practice Address - Street 1:1337 S INTERNATIONAL PKWY STE 1341
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-1402
Practice Address - Country:US
Practice Address - Phone:813-978-9700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TALLAHASSEE ORTHOPEDIC CLINIC III, P.L.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-12-02
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies