Ortho Florida, LLC

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

Legal business name

ORTHO FLORIDA, LLC

Doing business as

Institute of Regenerative Orthopedics & Sports Medicine

Practice address

3333 W Commercial Blvd Ste 101
Fort Lauderdale, FL 33309-3424

Phone

(954) 751-6990

NPI assigned

Sep 23, 2021

Last updated

Sep 23, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

ORTHO FLORIDA, LLCAs reported in NPPES

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

Authorized official

Name

Dane Trask

Title

Ceo

Phone

(813) 747-1128

Specialties & licenses 1

Addresses

Other names 1

• Institute of Regenerative Orthopedics & Sports Medicine Doing business as

Part of

Ortho Florida LLC

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

{
    "created_epoch": "1632355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632355200000",
    "number": "1770254385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 PLAZA REAL STE 275",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334323999",
            "telephone_number": "561-300-1792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 W COMMERCIAL BLVD STE 101",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093424",
            "telephone_number": "954-751-6990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHO FLORIDA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORTHO FLORIDA, LLC",
        "enumeration_date": "2021-09-23",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-15",
        "status": "A",
        "authorized_official_last_name": "TRASK",
        "authorized_official_first_name": "DANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "813-747-1128"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Institute of Regenerative Orthopedics & Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Sports Medicine (Orthopaedic Surgery) Physician in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.