SOUTHEAST ORTHOPEDIC SPECIALISTS LLC NPI 1538952379

NPI Information

  • NPI: 1538952379
  • Provider Name: SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC
  • Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
  • Entity Type: Organization
  • Address: 300 SAINT ELIZABETH WAY STE 210
    ST JOHNS, FL
    ZIP 32259
  • Phone: (904) 634-0640

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NPI Details

SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC is a durable medical equipment medical supplies in St Johns, FL. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC NPI is 1538952379. The provider is registered as an organization entity type.

The provider's business location address is:

300 SAINT ELIZABETH WAY STE 210
ST JOHNS, FL
ZIP 32259-153
Phone: (904) 634-0640
Fax: (904) 634-0203

The provider's authorized official is Brett Puckett .
The authorized official title is President and has the following contact phone number (904) 634-0640.

The enumeration date for this NPI number is 5/24/2025 and was last updated on 5/24/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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