Provider Demographics
NPI:1174705644
Name:ORTHOPAEDIC ASSOCIATES USA PA
Entity type:Organization
Organization Name:ORTHOPAEDIC ASSOCIATES USA PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:VIDYA
Authorized Official - Middle Name:
Authorized Official - Last Name:DORAISWAMY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-680-2108
Mailing Address - Street 1:350 N PINE ISLAND RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1849
Mailing Address - Country:US
Mailing Address - Phone:954-476-8800
Mailing Address - Fax:954-746-1362
Practice Address - Street 1:350 N PINE ISLAND RD
Practice Address - Street 2:SUITE 200
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1849
Practice Address - Country:US
Practice Address - Phone:954-476-8800
Practice Address - Fax:954-476-1362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
FLME71406207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5360670001Medicare PIN
99519AMedicare UPIN
FL5360670001Medicare NSC
99519Medicare UPIN