SOUTHEAST ORTHOPEDIC SPECIALISTS, INC. (NPI# 1730500489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730500489 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST ORTHOPEDIC SPECIALISTS, INC. |
| Practice Address |
2300 Park Ave Suite 203 Orange Park FL 32073-5571 |
| Mailing Address |
6500 Bowden Rd Suite 103 Jacksonville FL 32216-8070 |
| Practice Telephone | 9046340640 |
| Practice Fax Number | 9046340203 |
| Mailing Telephone | 9046340640 |
| Mailing Fax Number | 9046746155 |
| Enumeration Date | 2013-12-26 |
| Last Update Date | 2015-12-30 |
| Authorized Official Name | GAVAN R DUFFY (PRESIDENT / CEO) |
| Authorized Official Telephone | 9046340640 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | FL | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295156941 | Southeast Orthopedic Specialists, Inc. | Specialist | 10475 Centurion Pkwy N Ste 220, Jacksonville, FL 32256-5004 | 2013-12-26 |
| 1922615830 | Southeast Orthopedic Specialists, Inc. | Orthopaedic Surgery | 2 Shircliff Way Ste 605, Jacksonville, FL 32204-4762 | 2020-09-24 |
| 1881179638 | Southeast Orthopedic Specialists, Inc. | Specialist | 4565 Us Highway 17 Ste 200, Fleming Island, FL 32003-4823 | 2018-09-27 |
| 1477058709 | Southeast Orthopedic Specialists, Inc. | Orthopaedic Surgery | 2001 County Road 210 W Ste 200, Saint Johns, FL 32259-2063 | 2018-03-28 |
| 1114383023 | Southeast Orthopedic Specialists, Inc. | Specialist | 15255 Max Leggett Pkwy, 5th Floor, Jacksonville, FL 32218-7273 | 2016-01-07 |
| 1730500497 | Southeast Orthopedic Specialists, Inc. | Specialist | 1658 St Vincents Way Ste 100, Middleburg, FL 32068-8447 | 2013-12-26 |
| 1629025820 | Southeast Orthopedic Specialists, Inc. | Orthopaedic Surgery | 2627 Riverside Ave, 3rd Floor, Jacksonville, FL 32204-4712 | 2006-05-31 |
| Street Address |
2300 PARK AVE SUITE 203 |
| City | ORANGE PARK |
| State | FL |
| Zip Code | 32073-5571 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194728303 | Paul A Bednarzyk | Internal Medicine | 2300 Park Ave, Suite 101-b, Orange Park, FL 32073-5572 | 2005-05-23 |
| 1538526157 | Tiffany Reshae Florence | Nurse Practitioner | 2300 Park Ave, Orange Park, FL 32073-5571 | 2016-01-27 |
| 1902261316 | Se Orthopedic Specialists | Non-Pharmacy Dispensing Site | 2300 Park Ave, Suite 203, Orange Park, FL 32073-5571 | 2015-12-30 |
| 1568852739 | Jason M Fetty | Physical Therapist | 2300 Park Ave, Suite 203, Orange Park, FL 32073-5571 | 2015-01-27 |
| 1023445004 | Nedzad Cavka | Physical Therapist | 2300 Park Ave, Suite 203, Orange Park, FL 32073-5571 | 2013-10-04 |
| 1104163138 | Krystal Jane Newbern | Physical Therapist | 2300 Park Ave, Suite 203, Orange Park, FL 32073-5571 | 2013-01-10 |
| 1235489287 | Mark A Arrigenna | Physician Assistant | 2300 Park Ave, Suite 203, Orange Park, FL 32073-5571 | 2012-09-18 |
| 1841578556 | The Smart Group, LLC | Pharmacy | 2300 Park Ave, Suite 100, Orange Park, FL 32073-5571 | 2011-07-29 |
| 1912136292 | Housecall Home Health, L.L.C. | Home Health | 2300 Park Ave, Suite 102, Orange Park, FL 32073-5571 | 2009-07-08 |
| 1083861751 | James Brandon Causey | Physical Therapist | 2300 Park Ave, Suite 203, Orange Park, FL 32073-5571 | 2008-08-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891309423 | Kingsley Endoscopy Center LLC | Clinic/Center | 970 Kingsley Avenue, Orange Park, FL 32073 | 2020-09-01 |
| 1962028688 | Esra Sari | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue., Orange Park Medical Center, Orange Park, FL 32073 | 2020-06-18 |
| 1104441146 | Zeshan Tariq Malik | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue, Office of Graduate Medical Educa, Orange Park, FL 32073 | 2020-06-16 |
| 1902421894 | Ameer Hamza | Student in an Organized Health Care Education/Training Program | 2001, Kingsley Avenue Office of Graduate Medical Educat, Orange Park, FL 32073 | 2020-06-16 |
| 1497378103 | Fawad Ahmed Rashid | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue Office of Graduate Medical Educati, Orange Park, FL 32073 | 2020-05-28 |
| 1477174985 | Hannan Asghar | Student in an Organized Health Care Education/Training Program | Office of Graduate Medical Education 2001 Kingsley, Orange Park, FL 32073 | 2020-05-06 |
| 1902427156 | Emmanuel Iyanuloluwa Morakinyo | Student in an Organized Health Care Education/Training Program | 413 Deer View Avenue, 2001 Kingsley Ave, Orange Park, FL 32073 | 2020-04-29 |
| 1437799327 | Dalande Leger | Behavior Technician | 1563 Kingsley Ave Suite 103, Orange Park, FL 32073 | 2020-01-08 |
| 1215598313 | Mohammad Harisullah Khan | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Gme Office, Orange Park, FL 32073 | 2019-06-28 |
| 1558927970 | Preetha Kamath | Student in an Organized Health Care Education/Training Program | Orange Park Medical Center, 2001 Kingsley Ave, Orange Park, FL 32073 | 2019-05-10 |
| Find all providers in zip 32073 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134443583 | Medical Neurodiagnostics & Neurology Pl | Specialist | 1536 Kingsley Ave Ste 116, Orange Park, FL 32073-4525 | 2010-03-15 |
| 1841469459 | Carrie A Kissinger | Specialist | 2256 Hopkins St, Orange Park, FL 32073-5222 | 2008-02-27 |
| 1710934930 | Jacksonville Neurological Clinic, P.a. | Specialist | 1895 Kingsley Ave Ste 805, Orange Park, FL 32073-4410 | 2006-05-31 |
| 1588619068 | Olabisi T Rashied-walker | Specialist | 401 Cottage Cove Ct, Orange Park, FL 32073 | 2006-05-23 |
| 1598734154 | Mihaela Ionescu | Specialist | 1536 Kingsley Ave Ste 118, Orange Park, FL 32073-4525 | 2006-03-16 |
| 1053388306 | Anjan R Parghi | Specialist | 847 Park Ave, Orange Park, FL 32073 | 2006-03-07 |
| 1659357705 | Laurie Valloneshimko | Specialist | 1626 Sheffield Pl, Orange Park, FL 32073-5268 | 2005-12-21 |
| 1114900115 | James Sloan | Specialist | 653 Kingsley Ave, Orange Park, FL 32073-5467 | 2005-11-22 |
| 1346240504 | Rajesh Kumar Vishen | Specialist | 165 Wells Rd, Orange Park, FL 32073-3035 | 2005-07-28 |
| 1184627374 | Melissa C Kirby | Specialist | 1600 Park Ave, Ste 7, Orange Park, FL 32073-4999 | 2005-05-23 |
| Find all providers in ORANGE PARK | ||||
| City | ORANGE PARK |
| Zip Code | 32073 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.