NPIMap

Organization Active NPI

Ortho Florida LLC

Doing business as Sports Ortho LLC

  • Orthopaedic Surgery Physician
  • Coconut Creek, FL
National Provider Identifier
1689949224
Registry record updated Sep 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ORTHO FLORIDA LLC
Doing business as
Sports Ortho LLC
Practice address
3880 Coconut Creek Pkwy
Suite 303
Coconut Creek, FL 33066-1652
Phone
(561) 826-2000
Fax
(561) 826-2600
NPI assigned
Mar 15, 2012
Last updated
Sep 6, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
ORTHO FLORIDA LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 6, 2013

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

Authorized official

Name
Shatina Cannon
Title
Manager
Phone
(561) 826-2000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X
Orthopaedic Surgery Physician 207X00000X Primary

Addresses

Primary practice location

3880 Coconut Creek Pkwy
Suite 303
Coconut Creek, FL 33066-1652

Mailing address

9325 Glades Rd
Suite 205
Boca Raton, FL 33434-3988
Phone (561) 826-2000

Other names 1

  • Sports Ortho LLC Doing business as

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": "1331769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378425600000",
    "number": "1689949224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9325 GLADES RD",
            "address_2": "SUITE 205",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334343988",
            "telephone_number": "561-826-2000",
            "fax_number": "561-826-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 COCONUT CREEK PKWY",
            "address_2": "SUITE 303",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330661652",
            "telephone_number": "561-826-2000",
            "fax_number": "561-826-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHO FLORIDA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORTHO FLORIDA LLC",
        "enumeration_date": "2012-03-15",
        "last_updated": "2013-09-06",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "SHATINA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "561-826-2000"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sports Ortho LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coconut Creek, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.