1861708570 NPI number — TOTAL ORTHOPAEDIC CARE, P.A.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861708570 NPI number — TOTAL ORTHOPAEDIC CARE, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOTAL ORTHOPAEDIC CARE, P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861708570
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4850 W OAKLAND PARK BLVD
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
LAUDERDALE LAKES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33313-7260
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-735-3535
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10794 PINES BLVD
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
PEMBROKE PINES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33026-3920
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-735-3535
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/19/2010

Additional Information

Authorized Official

Authorized Official Last Name:
BILODEAU
Authorized Official First Name:
DEBRA
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
954-735-3535

Provider Taxonomy Codes

  • Taxonomy code: 207XX0005X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 374173700 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 374173701 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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