NPIMap

Organization Active NPI

South Florida Orthopaedics & Sports Medicine, PA

  • Durable Medical Equipment & Medical Supplies
  • Port St Lucie, FL
National Provider Identifier
1609763440
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SOUTH FLORIDA ORTHOPAEDICS & SPORTS MEDICINE, PA
Practice address
1881 SE Tiffany Ave Ste 202
Port St Lucie, FL 34952-7567
Phone
(772) 288-2400
NPI assigned
Jun 23, 2025
Last updated
Jun 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Authorized official

Name
William E Carlson, MDNPI 1558344630
Title
President
Phone
(772) 288-2400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1881 SE Tiffany Ave Ste 202
Port St Lucie, FL 34952-7567

Mailing address

1050 SE Monterey Rd Ste 400
Stuart, FL 34994-4512
Phone (772) 288-2400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250811002243 FL DME Supplier - Physician - Orthopedic/Orthopedic Surgery 6406838895 Practice locations: Port St Lucie, FL

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory
Tax ID family
So FL Orth Sports Med10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

4560 Lantana Rd
Ste 100
Lake Worth, FL 33463
Phone (561) 797-3422

9401 SW Discovery Way
Ste 105
Port Saint Lucie, FL 34987

1050 SE Monterey Rd
Ste 11
Stuart, FL 34994
Phone (772) 419-0560

1050 SE Monterey Rd
Ste 204
Stuart, FL 34994
Phone (772) 781-5960

1050 SE Monterey Rd
Ste 304
Stuart, FL 34994

Practitioners & affiliated clinicians

Practitioners 79

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 79

NPI Registry JSON

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

{
    "created_epoch": "1750636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750636800000",
    "number": "1609763440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 SE MONTEREY RD STE 400",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944512",
            "telephone_number": "772-288-2400",
            "fax_number": "442-419-0143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 SE TIFFANY AVE STE 202",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527567",
            "telephone_number": "772-288-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH FLORIDA ORTHOPAEDICS & SPORTS MEDICINE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-23",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-288-2400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; 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.