NPIMap

Organization Active NPI

Ortho Florida, LLC

Doing business as Pain Care Specialist of FL

  • Interventional Pain Medicine Physician
  • Hollywood, FL
National Provider Identifier
1386913002
Registry record updated Sep 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
ORTHO FLORIDA, LLC
Doing business as
Pain Care Specialist of FL
Practice address
4350 Sheridan St
Ste 102
Hollywood, FL 33021-3556
Phone
(954) 322-8586
NPI assigned
Dec 27, 2011
Last updated
Sep 23, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
ORTHO FLORIDA, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 23, 2015

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X NU Primary

Addresses

Primary practice location

4350 Sheridan St
Ste 102
Hollywood, FL 33021-3556

Mailing address

660 Glades Road
Ste 460
Boca Raton, FL 33431-6465
Phone (561) 300-1774

Other names 1

  • Pain Care Specialist of FL Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160126002873 FL DME Supplier - Physician - General PracticeDME Supplier - Physician - Orthopedic/Orthopedic Surgery 3274616453 Practice locations: Hollywood, 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

NPI Registry JSON

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

{
    "created_epoch": "1324944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442966400000",
    "number": "1386913002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 GLADES ROAD",
            "address_2": "STE 460",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316465",
            "telephone_number": "561-300-1774",
            "fax_number": "561-300-1874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 SHERIDAN ST",
            "address_2": "STE 102",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213556",
            "telephone_number": "954-322-8586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHO FLORIDA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORTHO FLORIDA, LLC",
        "enumeration_date": "2011-12-27",
        "last_updated": "2015-09-23",
        "status": "A",
        "authorized_official_last_name": "TRASK",
        "authorized_official_first_name": "DANE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "813-787-1128"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pain Care Specialist of FL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; 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.