Organization Active NPI

Florida Medical Orthopedic and Spine Institute

  • Clinic/Center
  • Lake Mary, FL
National Provider Identifier
1669366779
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
FLORIDA MEDICAL ORTHOPEDIC AND SPINE INSTITUTE
Practice address
1210 S International Pkwy Ste 174
Lake Mary, FL 32746-1691
Phone
(407) 738-1575
NPI assigned
Jun 4, 2025
Last updated
Jun 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Authorized official

Name
Mrs. Rebekah Jackson
Title
Vice President
Phone
(407) 738-1575

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

1210 S International Pkwy Ste 174
Lake Mary, FL 32746-1691

Mailing address

1210 S International Pkwy Ste 174
Lake Mary, FL 32746-1691
Phone (407) 738-1575

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2327750Florida Medical Orthopedic1210 S International Pkwy, Suite 174, Lake Mary, FL 32746Certificate of waiverJul 28, 2027

National Provider Directory

National Provider Directory

Locations

1210 S International Pkwy
Ste 174
Lake Mary, FL 32746
Phone (407) 333-4300

NPI Registry JSON

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

{
    "created_epoch": "1748995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749081600000",
    "number": "1669366779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 S INTERNATIONAL PKWY STE 174",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327461691",
            "telephone_number": "407-738-1575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 S INTERNATIONAL PKWY STE 174",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327461691",
            "telephone_number": "407-738-1575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA MEDICAL ORTHOPEDIC AND SPINE INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-04",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "REBEKAH",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "407-738-1575",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.