OrganizationActive
Southeast Orthopedic Specialists, LLC
NPI 1992598734 · Non-Pharmacy Dispensing Site · St Johns, FL
Provider details
- NPI number
- 1992598734
- Entity type
- Organization
- Primary specialty
- Non-Pharmacy Dispensing SiteSuppliers
- Organization subpart
- No
- Authorized official
- Brett Puckett, President(904) 634-0640
Specialties & taxonomies
Suppliers
Profile Score
Established profile(54/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
300 Saint Elizabeth Way Ste 210
St Johns, FL 32259-1153
Phone: (904) 634-0640
Fax: (904) 634-0203
Approximate (ZIP-level) locationGet directions
Mailing address
6800 Southpoint Pkwy Ste 300
Jacksonville, FL 32216-8203
Registry dates
- Enumerated
- 2025-05-24
- Last updated
- 2025-05-24
- Certified
- 2025-05-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.