Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Southeast Orthopedic Specialists, LLC

Orthopaedic Surgery Physician in Jacksonville, FL · enumerated 2006 · authorized official Brett Puckett, Authorized Official.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1629025820

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Registry record

Entity type Organization (Type 2)

Legal business name Southeast Orthopedic Specialists, LLC

Other name <Unavail>

Practice address 14534 Old Saint Augustine Rd Ste 3210, Jacksonville, FL, 32258

Phone (904) 675-4000

Fax (904) 675-4007

Enumeration date May 31, 2006

Last updated in NPPES Jun 10, 2026

Taxonomy & classification

174400000X Specialist Other Service Providers Secondary

207QS0010X Sports Medicine (Family Medicine) Physician Allopathic & Osteopathic Physicians Secondary

207X00000X Orthopaedic Surgery Physician Allopathic & Osteopathic Physicians Primary

207XS0106X Orthopaedic Hand Surgery Physician Allopathic & Osteopathic Physicians Secondary

207XS0114X Adult Reconstructive Orthopaedic Surgery Physician Allopathic & Osteopathic Physicians Secondary

207XX0004X Orthopaedic Foot and Ankle Surgery Physician Allopathic & Osteopathic Physicians Secondary

207XX0005X Sports Medicine (Orthopaedic Surgery) Physician Allopathic & Osteopathic Physicians Secondary

207XX0801X Orthopaedic Trauma Physician Allopathic & Osteopathic Physicians Secondary

208VP0000X Pain Medicine Physician Allopathic & Osteopathic Physicians Secondary

208VP0014X Interventional Pain Medicine Physician Allopathic & Osteopathic Physicians Secondary

213E00000X Podiatrist Podiatric Medicine & Surgery Service Providers Secondary

Authorized official

Name Brett Puckett

Title Authorized Official

Phone (904) 634-0640

Other identifiers

Identifier	Type	State	Issuer
107540813	Medicaid	FL	-
107540814	Medicaid	FL	-
107540819	Medicaid	FL	-
107540818	Medicaid	FL	-
107540800	Medicaid	FL	-
107540805	Medicaid	FL	-
107540807	Medicaid	FL	-
107540810	Medicaid	FL	-
107540817	Medicaid	FL	-
107540816	Medicaid	FL	-
107540808	Medicaid	FL	-
107540811	Medicaid	FL	-

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

What is a Type 2 NPI?

A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

What type of organization is Southeast Orthopedic Specialists, LLC?

Southeast Orthopedic Specialists, LLC is registered in NPPES as a Orthopaedic Surgery Physician (its primary provider taxonomy).

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2026-06-10.