| Institute Of Regenerative Orthopedics And Sports Medicine Llc | |
|
3333 W Commercial Blvd Ste 101 Fort Lauderdale FL 33309-3424 | |
| (786) 566-0338 | |
| Not Available |
| Full Name | Institute Of Regenerative Orthopedics And Sports Medicine Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3333 W Commercial Blvd Ste 101, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Jorge Antonio Gonzalez (OWNER) |
| Authorized Official Contact | 7865660338 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Institute Of Regenerative Orthopedics And Sports Medicine Llc 1441 Ne 54th St Fort Lauderdale FL 33334-4932 Ph: () - | Institute Of Regenerative Orthopedics And Sports Medicine Llc 3333 W Commercial Blvd Ste 101 Fort Lauderdale FL 33309-3424 Ph: (786) 566-0338 |
| NPI Number | 1194303487 |
|---|---|
| Provider Enumeration Date | 03/30/2021 |
| Last Update Date | 02/21/2022 |
| Medicare PECOS PAC ID | 7012300015 |
|---|---|
| Medicare Enrollment ID | O20220216001076 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194303487 | NPI | - | NPPES |
| 017619600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RS0010X | Internal Medicine - Sports Medicine | (* (Not Available)) | Primary |
| Provider Name | Jorge Gonzalez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427390137 PECOS PAC ID: 5698917623 Enrollment ID: I20160712002676 |
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