Provider Demographics
NPI:1861538902
Name:RESTORATION ORTHOPEDICS
Entity type:Organization
Organization Name:RESTORATION ORTHOPEDICS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-325-1131
Mailing Address - Street 1:1350 TAMIAMI TRL N
Mailing Address - Street 2:#203
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5203
Mailing Address - Country:US
Mailing Address - Phone:239-325-1131
Mailing Address - Fax:239-262-5980
Practice Address - Street 1:1350 TAMIAMI TRL N
Practice Address - Street 2:#203
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5203
Practice Address - Country:US
Practice Address - Phone:239-325-1131
Practice Address - Fax:239-262-5980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0063476207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK3821Medicare PIN