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

Southeast Orthopedic Specialists, LLC

Organization Specialist · NPI 1477058709

Southeast Orthopedic Specialists, LLC is a Specialist in Saint Johns, Florida. Registered with an NPI since 2018.

In the registry since
2018
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2001 County Road 210 W Ste 200
Saint Johns, FL 32259-2063
Phone: (904) 634-0640
Fax: (904) 634-0203
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X
Orthopaedic Surgery Physician Taxonomy 207X00000X

Record details

NPI number1477058709
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Brett Puckett — Vp · (904) 634-0640
NPI enumeratedMarch 28, 2018
Last updated in NPPESDecember 12, 2022
Certification dateDecember 12, 2022
Mailing address6800 Southpoint Pkwy Ste 300, Jacksonville, FL 32216-8203

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