Provider Demographics
NPI:1447006408
Name:FEDERAL ORTHOPEDIC SOLUTIONS, LLC
Entity type:Organization
Organization Name:FEDERAL ORTHOPEDIC SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-743-2111
Mailing Address - Street 1:1290 WOODS LANDING DR
Mailing Address - Street 2:
Mailing Address - City:MINNEOLA
Mailing Address - State:FL
Mailing Address - Zip Code:34715-6070
Mailing Address - Country:US
Mailing Address - Phone:727-743-2111
Mailing Address - Fax:
Practice Address - Street 1:1400 N US HIGHWAY 441 STE 906
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-6811
Practice Address - Country:US
Practice Address - Phone:352-234-8340
Practice Address - Fax:888-477-2586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT26872OtherFLORIDA LICENSE
FLME99986OtherFLORIDA LICENSE