Healthcare Provider Details

I. General information

NPI: 1568305472
Provider Name (Legal Business Name): JSC PEDORTHICS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 PHILIPS HWY STE 15
JACKSONVILLE FL
32216-6058
US

IV. Provider business mailing address

6900 PHILIPS HWY STE 15
JACKSONVILLE FL
32216-6058
US

V. Phone/Fax

Practice location:
  • Phone: 386-437-0272
  • Fax: 386-437-0256
Mailing address:
  • Phone: 386-437-0272
  • Fax: 386-437-0256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: ROBERT ORR
Title or Position: OWNER/PRESIDENT
Credential: CPO
Phone: 904-307-6487