Provider Demographics
NPI:1912861097
Name:TALLAHASSEE ORTHOPEDIC CLINIC III, P.L.
Entity type:Organization
Organization Name:TALLAHASSEE ORTHOPEDIC CLINIC III, P.L.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-579-2733
Mailing Address - Street 1:5901 E FOWLER AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-2305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1002 N ARNOLD RD UNIT 201
Practice Address - Street 2:
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32413-2524
Practice Address - Country:US
Practice Address - Phone:850-877-8174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TALLAHASSEE ORTHOPEDIC CLINIC III, P.L.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-12-12
Last Update Date:2025-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No3336C0002XSuppliersPharmacyClinic Pharmacy