MEDICARE: R & L ORTHOPEDIC SHOES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier
2	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104807734
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	R & L ORTHOPEDIC SHOES INC

Provider Business Mailing Address
First Line	:	11455 FLORIDA BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70815-2404
Country	:	US
Telephone Number	:	225-275-2632
Fax Number	:	225-275-3238

Provider Business Practice Location Address
First Line	:	11455 FLORIDA BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70815-2404
Country	:	US
Telephone Number	:	225-275-2632
Fax Number	:	225-275-3238

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ESTEBAN BOTELLO
Credential	:
Telephone Number	:	225-275-2632

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	03/29/2011

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Directions to “R & L ORTHOPEDIC SHOES INC ” Practice Location

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