Florida Orthopedics and Neurosurgery LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

ME81066 Issued in FL

Legal business name

FLORIDA ORTHOPEDICS AND NEUROSURGERY LLC

Practice address

1855 SE Port St Lucie Blvd
Port St Lucie, FL 34952-5530

Phone

(772) 467-2677

Fax

(772) 467-2621

NPI assigned

Jul 13, 2017

Organization subpart

No

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

Authorized official

Name

Michael Wycoki Jr.

Title

Manager

Phone

(772) 467-2677

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499904000000",
    "number": "1831611516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 N US HIGHWAY 1",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349466434",
            "telephone_number": "772-467-2677",
            "fax_number": "772-467-2621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 SE PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525530",
            "telephone_number": "772-467-2677",
            "fax_number": "772-467-2621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA ORTHOPEDICS AND NEUROSURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-13",
        "last_updated": "2017-07-13",
        "status": "A",
        "authorized_official_last_name": "WYCOKI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "772-467-2677",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "FL",
            "license": "ME81066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Medical Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2017; 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.