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SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC
NPI 1003542465
Durable Medical Equipment & Medical Supplies in St Johns, FL

Active since July 28, 2022
3055 COUNTY ROAD 210 W STE 110, ST JOHNS, FL 32259(904) 634-0640(904) 634-0203 Get Directions Write a Review

NPPES record last updated: March 8, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 8, 2023, Jul 28, 2022 (2 updates tracked since 2022).

About Southeast Orthopedic Specialists, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC (NPI 1003542465) is a healthcare organization registered as a durable medical equipment & medical supplies in St Johns, Florida and active in the NPI registry since July 2022. The organization lists Brett Puckett, Md, as its authorized official.

NPPES Registry Identity

NPI1003542465
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NameSOUTHEAST ORTHOPEDIC SPECIALISTS, LLC
Location Address3055 COUNTY ROAD 210 W STE 110St Johns, FL 32259-7001
Mailing Address6800 Southpoint Pkwy Ste 300Jacksonville, FL 32216-8203 · (904) 634-0640 · Fax (904) 634-0203
Phone(904) 634-0640
Fax(904) 634-0203
Organization SubpartNo
Authorized OfficialBrett PuckettMd · (904) 634-0640
Enumeration DateJuly 28, 2022
Last NPPES UpdateMarch 8, 20232 updates tracked since enumeration
NPPES CertifiedMarch 8, 2023
✔ NPI 1003542465 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
Definition

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.

Also ListedDurable Medical Equipment & Medical Supplies · Customized EquipmentTaxonomy 332BC3200X
Also ListedProsthetic/Orthotic SupplierTaxonomy 335E00000X
3055 COUNTY ROAD 210 W STE 110, St Johns, FL 32259
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Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAYLA JEANNE STADIUS PT, DPT, EP-C
Physical Therapist
3055 COUNTY ROAD 210 W STE 110
ST JOHNS, FL 32259
St. Johns County (904) 634-0640
HANNAH LOWDEN PT, DPT
Physical Therapist
3055 COUNTY ROAD 210 W STE 110
ST JOHNS, FL 32259
St. Johns County (904) 634-0640
SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC
Orthopaedic Surgery
3055 COUNTY ROAD 210 W STE 110
ST JOHNS, FL 32259
St. Johns County (904) 634-0203
ADAM KLAROWSKI
Physical Therapist
3055 COUNTY ROAD 210 W STE 110
ST JOHNS, FL 32259
St. Johns County (904) 634-0640
YEKATERINA FERRARO
Physical Therapist
3055 COUNTY ROAD 210 W STE 110
ST JOHNS, FL 32259
St. Johns County (904) 634-0640
SOUTHEAST ORTHOPEDIC SPECIALISTS, INC
Non-Pharmacy Dispensing Site
3055 COUNTY ROAD 210 W STE 110
ST JOHNS, FL 32259
St. Johns County (904) 634-0640
MRS. JUANITA DENAE BRACY PA-C, MPA, ATC, MED.
Physician Assistant
3055 COUNTY ROAD 210 W STE 110
ST JOHNS, FL 32259
St. Johns County (214) 580-7277
CHARLES LUND DPT
Physical Therapist
3055 COUNTY ROAD 210 W STE 110
ST JOHNS, FL 32259
St. Johns County (904) 634-0640

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southeast Orthopedic Specialists, LLC's NPI number?

The NPI number for Southeast Orthopedic Specialists, LLC is 1003542465. It was assigned to this organization in the NPPES registry on July 28, 2022.

Where is Southeast Orthopedic Specialists, LLC located?

Southeast Orthopedic Specialists, LLC is located at 3055 County Road 210 W Ste 110, St Johns, FL 32259. The listed phone number is (904) 634-0640.

What is Southeast Orthopedic Specialists, LLC's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

When was this NPI record last updated?

The NPPES record for Southeast Orthopedic Specialists, LLC was last updated on March 8, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.