James Provo (NPI# 1346278264, PAC ID# 8123921350) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is SPORTS MEDICINE.
| Nation Provider ID (NPI) | 1346278264 |
| PAC ID by PECOS | 8123921350 |
| Professional Enrollment ID | I20040127000894 |
| Full Name | James Provo |
| Organization Legal Name | SPORTS AND ORTHOPEDIC CENTER PA |
| Address |
6280 W Sample Rd Suite 203 Coral Springs FL 33067-3173 |
| Phone Number | 9544819942 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE |
| Graduation Year | 1990 |
| Primary Specialty | SPORTS MEDICINE |
| Group Practice PAC ID | 3072834480 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100168 | BOCA RATON REGIONAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 9325 Glades Rd, Suite 205, Boca Raton, FL 33434-3988 | 9544819942 | SPORTS AND ORTHOPEDIC CENTER PA |
| 6280 W Sample Rd, Suite 203, Coral Springs, FL 33067-3173 | 9544819942 | SPORTS AND ORTHOPEDIC CENTER PA |
| Organization Legal Name | SPORTS AND ORTHOPEDIC CENTER PA |
| Physicians | 7 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ty Quint | Physician Assistant | Sports and Orthopedic Center Pa | 6280 W Sample Rd, Suite 203, Coral Springs, FL 33067-3173 |
| Francis Moll Iii | Orthopedic Surgery | Sports and Orthopedic Center Pa | 6280 W Sample Rd, Suite 203, Coral Springs, FL 33067-3173 |
| Nicholas Mataragas | Orthopedic Surgery | Sports and Orthopedic Center Pa | 3428 N Roosevelt Blvd, Key West, FL 33040-4224 |
| Gary J Edman | Physician Assistant | Sports and Orthopedic Center Pa | 6280 W Sample Rd, Suite 203, Coral Springs, FL 33067-3173 |
| Manish K Gupta | Orthopedic Surgery | Sports and Orthopedic Center Pa | 6280 W Sample Rd, Suite 203, Coral Springs, FL 33067-3173 |
| Jordan G Kuppinger | Anesthesiology | Sports and Orthopedic Center Pa | 6280 W Sample Rd, Suite 203, Coral Springs, FL 33067-3173 |
| Street Address |
6280 W SAMPLE RD SUITE 203 |
| City | CORAL SPRINGS |
| State | FL |
| Zip | 33067-3173 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ty Quint | Physician Assistant | Sports and Orthopedic Center Pa | 6280 W Sample Rd, Suite 203, Coral Springs, FL 33067-3173 |
| Francis Moll Iii | Orthopedic Surgery | Sports and Orthopedic Center Pa | 6280 W Sample Rd, Suite 203, Coral Springs, FL 33067-3173 |
| Gary J Edman | Physician Assistant | Sports and Orthopedic Center Pa | 6280 W Sample Rd, Suite 203, Coral Springs, FL 33067-3173 |
| Manish K Gupta | Orthopedic Surgery | Sports and Orthopedic Center Pa | 6280 W Sample Rd, Suite 203, Coral Springs, FL 33067-3173 |
| Jordan G Kuppinger | Anesthesiology | Sports and Orthopedic Center Pa | 6280 W Sample Rd, Suite 203, Coral Springs, FL 33067-3173 |
| Tracy Passerotti | Physician Assistant | Orthopedic Center of Palm Beach County | 6280 W Sample Rd, Suite 202, Coral Springs, FL 33067-3173 |
| Alyssa Janosko | Physician Assistant | Orthopedic Center of Palm Beach County | 6280 W Sample Rd, Coral Springs, FL 33067-3173 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Katherine A Einman | Nurse Practitioner | Swallowing Diagnostics Inc | 6093 Nw 62nd Ter, Parkland, FL 33067-1538 |
| Samantha Faith Rojas | Nurse Practitioner | Swallowing Diagnostics Inc | 6093 Nw 62nd Ter, Parkland, FL 33067-1538 |
| Cynthia S Abraham | Nurse Practitioner | Swallowing Diagnostics Inc | 6093 Nw 62nd Ter, Parkland, FL 33067-1538 |
| Antoinette Troxler Watson | Nurse Practitioner | Swallowing Diagnostics Inc | 6093 Nw 62nd Ter, Parkland, FL 33067-1538 |
| Albert R Cioffi | General Surgery | Swallowing Diagnostics Inc | 6093 Nw 62nd Ter, Parkland, FL 33067-1538 |
| Kimar R Catala | Nurse Practitioner | Swallowing Diagnostics Inc | 6093 Nw 62nd Ter, Parkland, FL 33067-1538 |
| Joseph M Bogart | Chiropractic | Joseph Bogart Dc Pa | 6662 Parkside Dr, Parkland, FL 33067-1694 |
| Joseph Anthony Perez | Chiropractic | Joseph Bogart Dc Pa | 6662 Parkside Dr, Parkland, FL 33067-1694 |
| Bruce J Cherlow | Chiropractic | 6662 Parkside Dr, Parkland, FL 33067-1694 | |
| Marifran Ramaglia | Qualified Audiologist | 9160 B Wiles Rd, Coral Springs, FL 33067-1999 | |
| Find all physicians in zip 33067 | |||
| City | CORAL SPRINGS |
| Zip Code | 33067 |
| Specialty | SPORTS MEDICINE |
| City + Specialty | CORAL SPRINGS + SPORTS MEDICINE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.