NPIMap

Organization Active NPI

Ortho Florida, LLC

Doing business as South Miami Walk-in Orthopedics

  • Sports Medicine (Emergency Medicine) Physician
  • South Miami, FL
National Provider Identifier
1023539574
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X
Legal business name
ORTHO FLORIDA, LLC
Doing business as
South Miami Walk-in Orthopedics
Practice address
5966 S Dixie Hwy Ste 401
South Miami, FL 33143-5177
Phone
(786) 453-2667
NPI assigned
Jul 5, 2017
Last updated
Jan 7, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
ORTHO FLORIDA, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dane Trask
Title
Ceo
Phone
(813) 787-1128

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Emergency Medicine) Physician 207PS0010X NU Primary

Addresses

Primary practice location

5966 S Dixie Hwy Ste 401
South Miami, FL 33143-5177

Mailing address

PO Box 978766
Dallas, TX 75397-8766
Phone (561) 300-1792

Other names 1

  • South Miami Walk-in Orthopedics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170929002676 FL DME Supplier - Sports Medicine 3274616453 Practice locations: South Miami, FL

Other NPIs with the same Medicare PAC ID 20

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 20

National Provider Directory

National Provider Directory
Tax ID family
Ortho Florida LLC46 organizations share this tax ID, including this one
Part of
Ortho Florida LLC

Other organizations with this tax ID 45

Organizations that report the same tax identification number in the National Provider Directory.

View all 45

Locations

5966 S Dixie Hwy
Ste 401
South Miami, FL 33143
Phone (786) 453-2667

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578355200000",
    "number": "1023539574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 978766",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753978766",
            "telephone_number": "561-300-1792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5966 S DIXIE HWY STE 401",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331435177",
            "telephone_number": "786-453-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHO FLORIDA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORTHO FLORIDA, LLC",
        "enumeration_date": "2017-07-05",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A",
        "authorized_official_last_name": "TRASK",
        "authorized_official_first_name": "DANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "813-787-1128"
    },
    "taxonomies": [
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Miami Walk-in Orthopedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.