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SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC
NPI 1477058709
Specialist in Saint Johns, FL

Active since March 28, 2018
2001 COUNTY ROAD 210 W STE 200, SAINT JOHNS, FL 32259(904) 634-0640(904) 634-0203 Get Directions Write a Review

NPPES record last updated: December 12, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 12, 2022, Sep 27, 2018, Mar 28, 2018 (3 updates tracked since 2018).

About Southeast Orthopedic Specialists, Llc NPPES

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

SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC (NPI 1477058709) is a healthcare organization registered as a specialist in Saint Johns, Florida and active in the NPI registry since March 2018. The organization lists Brett Puckett, Vp, as its authorized official.

NPPES Registry Identity

NPI1477058709
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameSOUTHEAST ORTHOPEDIC SPECIALISTS, LLC
Location Address2001 COUNTY ROAD 210 W STE 200Saint Johns, FL 32259-2063
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 PuckettVp · (904) 634-0640
Enumeration DateMarch 28, 2018
Last NPPES UpdateDecember 12, 20223 updates tracked since enumeration
NPPES CertifiedDecember 12, 2022
✔ NPI 1477058709 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Also ListedOrthopaedic SurgeryTaxonomy 207X00000X
2001 COUNTY ROAD 210 W STE 200, Saint Johns, FL 32259
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Other Identifiers 1

OtherK4080FL · Medicare

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

Other Providers at the Same Location NPPES 2

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

AUSTIN J CHAPUT D.O.
Family Medicine
2001 COUNTY ROAD 210 W STE 200
JACKSONVILLE, FL 32259
St. Johns County (904) 450-8120
DR. JAMI S WEBSTER M.D.
Pediatrics
2001 COUNTY ROAD 210 W STE 200
ST JOHNS, FL 32259
St. Johns County (044) 508-1209

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 1477058709. It was assigned to this organization in the NPPES registry on March 28, 2018.

Where is Southeast Orthopedic Specialists, LLC located?

Southeast Orthopedic Specialists, LLC is located at 2001 County Road 210 W Ste 200, Saint 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 Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Southeast Orthopedic Specialists, LLC was last updated on December 12, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.