Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Florida Sports Medicine Institute Inc

Organization Sports Medicine (Orthopaedic Surgery) Physician · NPI 1346341476

Florida Sports Medicine Institute Inc is a Sports Medicine (Orthopaedic Surgery) Physician in St Augustine, Florida. Licensed in Florida. Registered with an NPI since 2006.

Licensed in
FL
In the registry since
2006
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

150 Southpark Blvd Ste 102
St Augustine, FL 32086-5190
Phone: (904) 823-3764
Fax: (904) 429-0318
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Orthopaedic Surgery) Physician (primary) Taxonomy 207XX0005X · Licence OS7217 (FL)
Sports Medicine (Orthopaedic Surgery) Physician Taxonomy 207XX0005X · Licence ME93573 (FL)

Record details

NPI number1346341476
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Karen Haseltine — C.E.O. · (904) 823-3764
NPI enumeratedSeptember 25, 2006
Last updated in NPPESJanuary 5, 2017
Mailing address150 Southpark Blvd, Suite 102, St Augustine, FL 32086-5190

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