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SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC
NPI 1730500489
Orthopaedic Surgery in Orange Park, FL

Active since December 26, 2013
2300 PARK AVE, SUITE 203, ORANGE PARK, FL 32073(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: August 02, 2026.

Record update history: Dec 12, 2022, Dec 30, 2015 (2 updates tracked since 2015).

About Southeast Orthopedic Specialists, Llc NPPES

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

SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC (NPI 1730500489) is a healthcare organization registered as an orthopaedic surgery in Orange Park, Florida and active in the NPI registry since December 2013. The organization lists Brett Puckett, Vp, as its authorized official.

NPPES Registry Identity

NPI1730500489
Entity TypeOrganization
Primary Taxonomy207X00000X
Legal Business NameSOUTHEAST ORTHOPEDIC SPECIALISTS, LLC
Location Address2300 PARK AVE, SUITE 203Orange Park, FL 32073-5571
Mailing Address6800 Southpoint Pkwy Ste 300Jacksonville, FL 32216-8203 · (904) 634-0640 · Fax (904) 674-6155
Phone(904) 634-0640
Fax(904) 634-0203
Organization SubpartNo
Authorized OfficialBrett PuckettVp · (904) 634-0640
Enumeration DateDecember 26, 2013
Last NPPES UpdateDecember 12, 20222 updates tracked since enumeration
NPPES CertifiedDecember 12, 2022
✔ NPI 1730500489 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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.
Also ListedSpecialistTaxonomy 174400000X
2300 PARK AVE, Orange Park, FL 32073
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Group Practice 2

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP
Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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 ›

Other Providers at the Same Location NPPES 11

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

NEDZAD CAVKA PT
Physical Therapist
2300 PARK AVE, SUITE 203
ORANGE PARK, FL 32073
Clay County (904) 634-0640
KRYSTAL JANE NEWBERN D.P.T.
Physical Therapist
2300 PARK AVE, SUITE 203
ORANGE PARK, FL 32073
Clay County (904) 634-0640
DR. PAUL A BEDNARZYK MD
Internal Medicine (Cardiovascular Disease)
2300 PARK AVE, SUITE 101-B
ORANGE PARK, FL 32073
Clay County (904) 264-0088
DRS. MCCLOW, CLARK & BERK PA
Radiology (Diagnostic Radiology)
2300 PARK AVE
ORANGE PARK, FL 32073
Clay County (904) 215-2580
PAUL DAVID SHIRLEY M.D.
Orthopaedic Surgery (Sports Medicine)
2300 PARK AVE, SUITE 203
ORANGE PARK, FL 32073
Clay County (904) 634-0640
TIFFANY RESHAE FLORENCE ARNP
Nurse Practitioner (Family)
2300 PARK AVE
ORANGE PARK, FL 32073
Clay County (352) 208-4154
JASON M FETTY PT
Physical Therapist
2300 PARK AVE, SUITE 203
ORANGE PARK, FL 32073
Clay County (904) 634-0640
LIFETIME MEDICAL CARE PA
Clinic/Center (Primary Care)
2300 PARK AVE, SUITE 203
ORANGE PARK, FL 32073
Clay County (904) 278-0016

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 1730500489. It was assigned to this organization in the NPPES registry on December 26, 2013.

Where is Southeast Orthopedic Specialists, LLC located?

Southeast Orthopedic Specialists, LLC is located at 2300 Park Ave Suite 203, Orange Park, FL 32073. The listed phone number is (904) 634-0640.

What is Southeast Orthopedic Specialists, LLC's specialty?

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

What insurance does Southeast Orthopedic Specialists, LLC accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Southeast Orthopedic Specialists, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.