NPIMap

Organization Active NPI

Southeast Orthopedic Specialists, Inc

  • Non-Pharmacy Dispensing Site
  • Jacksonville, FL
National Provider Identifier
1972969756
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
ME80485 Issued in FL
Legal business name
SOUTHEAST ORTHOPEDIC SPECIALISTS, INC
Practice address
2627 Riverside Ave
Suite 300
Jacksonville, FL 32204-4712
Phone
(904) 634-0640
Fax
(904) 634-0203
NPI assigned
Jan 8, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

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

Authorized official

Name
Alexandra Mora
Title
Ancillary Manager, Physical Therapy
Phone
(904) 674-2023

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X ME80485 FL Primary

Addresses

Primary practice location

2627 Riverside Ave
Suite 300
Jacksonville, FL 32204-4712

Mailing address

6800 Southpoint Pkwy Ste 300
Jacksonville, FL 32216-8203
Phone (904) 634-0203

National Provider Directory

National Provider Directory
Tax ID family
Southeast Orthopedic Specialists Inc38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1452211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626134400000",
    "number": "1972969756",
    "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": "904-634-0203",
            "fax_number": "904-634-0203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 RIVERSIDE AVE",
            "address_2": "SUITE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044712",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST ORTHOPEDIC SPECIALISTS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-08",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A",
        "authorized_official_last_name": "MORA",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_title_or_position": "ANCILLARY MANAGER, PHYSICAL THERAPY",
        "authorized_official_telephone_number": "904-674-2023"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "FL",
            "license": "ME80485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

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