Provider Demographics
NPI:1043498595
Name:ORTHOPEDIC CENTER OF TITUSVILLE PL
Entity type:Organization
Organization Name:ORTHOPEDIC CENTER OF TITUSVILLE PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROJAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-268-0291
Mailing Address - Street 1:1855 JESS PARRISH CT
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32796-2123
Mailing Address - Country:US
Mailing Address - Phone:321-268-0291
Mailing Address - Fax:321-268-0201
Practice Address - Street 1:1855 JESS PARRISH CT
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-2123
Practice Address - Country:US
Practice Address - Phone:321-268-0291
Practice Address - Fax:321-268-0201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK4682Medicare PIN