Southeast Orthopedic Specialists, LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC

Practice address

2300 Park Ave
Suite 203
Orange Park, FL 32073-5571

Phone

(904) 634-0640

Fax

(904) 634-0203

NPI assigned

Dec 26, 2013

Organization subpart

No

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

Authorized official

Name

Brett Puckett

Title

VP

Phone

(904) 634-0640

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1388016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670803200000",
    "number": "1730500489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 SOUTHPOINT PKWY STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168203",
            "telephone_number": "904-634-0640",
            "fax_number": "904-674-6155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 PARK AVE",
            "address_2": "SUITE 203",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735571",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-26",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A",
        "authorized_official_last_name": "PUCKETT",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "904-634-0640"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonohope Imaging Services LLC
• Yuneisi Sorzano Herrero
• Daniella C Sousou, DMD
• Southeast Orthopedic Specialists, LLC
• Southeast Orthopedic Specialists, LLC
• Southeast Outpatient Consultants LLC
• Southeast Superior Health
• Southerly Home Health LLC
• Southern Baptist Hospital
• Aaron Souza, MD

• Orthopaedic Surgery Physician in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Orthopaedic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.