NPIMap

Organization Active NPI

Ortho Florida, LLC

Doing business as Advanced Podiatry Group

  • Foot & Ankle Surgery Podiatrist
  • Orlando, FL
National Provider Identifier
1124779665
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
ORTHO FLORIDA, LLC
Doing business as
Advanced Podiatry Group
Practice address
114 Park Lake St
Orlando, FL 32803-3822
Phone
(407) 423-9401
NPI assigned
Jan 17, 2022
Last updated
Jan 17, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
ORTHO FLORIDA, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

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) 747-1128

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

114 Park Lake St
Orlando, FL 32803-3822

Mailing address

433 Plaza Real Ste 275
Boca Raton, FL 33432-3999
Phone (561) 300-1792

Other names 1

  • Advanced Podiatry Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220307000312 FL DME Supplier - Physician - Podiatry 3274616453 Practice locations: Orlando, 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 LLC48 organizations share this tax ID, including this one
Part of
Ortho Florida LLC

Other organizations with this tax ID 47

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

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1642377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642377600000",
    "number": "1124779665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 PLAZA REAL STE 275",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334323999",
            "telephone_number": "561-300-1792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 PARK LAKE ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328033822",
            "telephone_number": "407-423-9401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHO FLORIDA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORTHO FLORIDA, LLC",
        "enumeration_date": "2022-01-17",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A",
        "authorized_official_last_name": "TRASK",
        "authorized_official_first_name": "DANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "813-747-1128"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Podiatry Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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.