Organization Active NPI

Orthopaedic Center of Venice PL

  • Orthopaedic Surgery Physician
  • Venice, FL
National Provider Identifier
1871780130
Registry record updated Feb 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
ME61283 Issued in FL
Legal business name
ORTHOPAEDIC CENTER OF VENICE PL
Practice address
241 Nokomis Ave S
Suite B
Venice, FL 34285-2319
Phone
(941) 485-3302
Fax
(941) 485-2673
NPI assigned
Oct 1, 2007
Last updated
Feb 21, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2008

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

Authorized official

Name
Dr. Julio Gonzalez, M.D.NPI 1083656128
Title
Owner
Phone
94148533302

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X ME61283 FL Primary

Addresses

Primary practice location

241 Nokomis Ave S
Suite B
Venice, FL 34285-2319

Mailing address

241 Nokomis Ave S
Suite B
Venice, FL 34285-2319
Phone (941) 485-3302

Other identifiers 2

IdentifierTypeStateIssuer
35812OtherFLBCBS
DB6741OtherFLRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040730000378 FL Part B Supplier - Clinic/Group Practice 6507836038 Receives reassigned benefits from 2 practitioners
Practice locations: Venice, FL
O20100930072492 FL DME Supplier - Physician - Orthopedic/Orthopedic Surgery 6507836038 Practice locations: Venice, FL

National Provider Directory

National Provider Directory

Locations

12169 Mercado Dr
Venice, FL 34293

241 Nokomis Ave S
#B
Venice, FL 34285

241 Nokomis Ave S
Ste B
Venice, FL 34285
Phone (374) 485-3302

600 Nokomis Ave S
Ste 101B
Venice, FL 34285
Phone (940) 485-3302

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203552000000",
    "number": "1871780130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 NOKOMIS AVE S",
            "address_2": "SUITE B",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342852319",
            "telephone_number": "941-485-3302",
            "fax_number": "941-485-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 NOKOMIS AVE S",
            "address_2": "SUITE B",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342852319",
            "telephone_number": "941-485-3302",
            "fax_number": "941-485-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDIC CENTER OF VENICE PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2008-02-21",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "JULIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "94148533302",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME61283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "35812",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DB6741",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.