Institute of Regenerative Orthopedics and Sports Medicine LLC

Primary specialty

Sports Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0010X

Legal business name

INSTITUTE OF REGENERATIVE ORTHOPEDICS AND SPORTS MEDICINE LLC

Practice address

3333 W Commercial Blvd Ste 101
Fort Lauderdale, FL 33309-3424

Phone

(786) 566-0338

NPI assigned

Mar 30, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Jorge Antonio Gonzalez, MDNPI 1427390137

Title

Owner

Phone

(786) 566-0338

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Institute of Regenerative Orthopedics and Sports Medicine LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Institute of Regenerative Orthopedics and Sports Medicine LLC

  • Interventional Pain Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1972475028
  NPD tax ID

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Institute of Regenerative Orthopedics & Spinal Medicine

  • Interventional Pain Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1629952734
  NPPES parent name
• Institute of Regenerative Orthopedics and Sports Medicine LLC

  • Interventional Pain Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1972475028
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jorge Antonio Gonzalez Jr., M.D.

  • Sports Medicine (Internal Medicine) Physician
  • Fort Lauderdale, FL
  • NPI 1427390137
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645401600000",
    "number": "1194303487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 NE 54TH ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333344932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 W COMMERCIAL BLVD STE 101",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093424",
            "telephone_number": "786-566-0338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSTITUTE OF REGENERATIVE ORTHOPEDICS AND SPORTS MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-30",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-566-0338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RS0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017619600",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jorgeagonzalezmd@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1441 NE 54th St",
            "city": "Fort Lauderdale",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333344932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Sports Medicine (Internal Medicine) Physician in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Sports Medicine (Internal Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.