SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC
NPI 1013629708
Orthopaedic Surgery in Jacksonville, FL

Q: What is Southeast Orthopedic Specialists, LLC's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Active since December 14, 2022CLIA 10D2277198 · Waiver

4268 OLDFIELD CROSSING DR STE 201, JACKSONVILLE, FL 32223(904) 634-0640 Get Directions Write a Review

NPPES record last updated: December 14, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Southeast Orthopedic Specialists, Llc NPPES

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

SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC (NPI 1013629708) is a healthcare organization registered as an orthopaedic surgery in Jacksonville, Florida and active in the NPI registry since December 2022. The organization holds a CLIA Waiver certificate valid through February 22, 2027 and lists Brett Puckett, Vp, as its authorized official.

NPPES Registry Identity

NPI1013629708

Entity TypeOrganization

Primary Taxonomy207X00000X

Legal Business NameSOUTHEAST ORTHOPEDIC SPECIALISTS, LLC

Location Address4268 OLDFIELD CROSSING DR STE 201Jacksonville, FL 32223-8800

Mailing Address6800 Southpoint Pkwy Ste 300Jacksonville, FL 32216-8203

Phone(904) 634-0640

Organization SubpartNo

Authorized OfficialBrett PuckettVp · (904) 634-0640

Enumeration DateDecember 14, 2022

NPPES CertifiedSeptember 28, 2022

✔ NPI 1013629708 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

4268 OLDFIELD CROSSING DR STE 201, Jacksonville, FL 32223

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2277198

Southeast Orthopedic Specialist LLC · Jacksonville, FL

Active · expires Feb 22, 2027

CLIA Number10D2277198

Laboratory TypePhysician Office

Certificate Effective DateFebruary 23, 2025

Certificate Expiration DateFebruary 22, 2027

Laboratory DirectorFrank Collier Jr

Laboratory Phone(904) 634-0640

Laboratory LocationSoutheast Orthopedic Specialist LLC10475 Centurion Pkwy N St 301, Jacksonville, FL 32256

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

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

JUSTIN MERKEL DPT

Physical Therapist