MEDICARE: INTEGRITY PROSTHETICS AND ORTHOTICS, LLC

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	PRO60	FL

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	:	1245469824
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRITY PROSTHETICS AND ORTHOTICS, LLC

Provider Business Mailing Address
First Line	:	2606 LAKELAND HILLS BLVD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33805-2218
Country	:	US
Telephone Number	:	863-937-9200
Fax Number	:

Provider Business Practice Location Address
First Line	:	2606 LAKELAND HILLS BLVD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33805-2218
Country	:	US
Telephone Number	:	863-937-9200
Fax Number	:	863-937-9199

Authorized Official
Title or Position	:	CPO LP
Name	:	MR. CLARENCE EDWARD CROWE II
Credential	:	CPO
Telephone Number	:	863-581-5833

Provider Enumeration Date	:	07/05/2009
Last Update Date	:	06/04/2026

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