Organization Name: | THE CENTER FOR BONE AND JOINT DISEASE |
NPI Number: | 1023446838 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CRAIG BENNETT (PRESIDENT) |
Mailing Address: | 7544 Jacque Rd Hudson |
State: | FL US |
Postal Code: | 346677162 |
Phone Number: | 7276972200 |
Fax Number: | 7278574352 |
NPI Enumeration Date: | 10/15/2013 |
NPI Last Update Date: | 10/15/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | PA9107481 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |