SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC
NPI 1922615830
Specialist in Jacksonville, FL

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

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Active since September 24, 2020

2 SHIRCLIFF WAY STE 605, JACKSONVILLE, FL 32204(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, Sep 28, 2022, Sep 25, 2020 (3 updates tracked since 2020).

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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 1922615830) is a healthcare organization registered as a specialist in Jacksonville, Florida and active in the NPI registry since September 2020. The organization lists Brett Christopher Puckett, President, as its authorized official.

NPPES Registry Identity

NPI1922615830

Entity TypeOrganization

Primary Taxonomy174400000X

Legal Business NameSOUTHEAST ORTHOPEDIC SPECIALISTS, LLC

Location Address2 SHIRCLIFF WAY STE 605Jacksonville, FL 32204-4762

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 Christopher PuckettPresident · (904) 634-0640

Enumeration DateSeptember 24, 2020

Last NPPES UpdateDecember 12, 20223 updates tracked since enumeration

NPPES CertifiedDecember 12, 2022

✔ NPI 1922615830 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

2 SHIRCLIFF WAY STE 605, Jacksonville, FL 32204

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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), Medica.Insurance ›

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.

DR. FARID A. HAKIM M.D.

Orthopaedic Surgery