Healthcare Provider Details

I. General information

NPI: 1427144914
Provider Name (Legal Business Name): CATCH A FALLING ARCH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 06/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10500 ULMERTON RD SUITE 240
LARGO FL
33771-3549
US

IV. Provider business mailing address

10500 ULMERTON RD SUITE 240
LARGO FL
33771-3549
US

V. Phone/Fax

Practice location:
  • Phone: 727-585-4200
  • Fax: 727-585-4700
Mailing address:
  • Phone: 727-585-4200
  • Fax: 727-585-4700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License NumberPED83
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberPED83
License Number StateFL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierM2736
Identifier TypeOTHER
Identifier StateFL
Identifier IssuerBLUE CROSS BLUE SHIELD FL
# 2
IdentifierCATCH A
Identifier TypeOTHER
Identifier StateGA
Identifier IssuerAARP
# 3
Identifier0007517452
Identifier TypeOTHER
Identifier StateKY
Identifier IssuerAETNA

VIII. Authorized Official

Name: LAURETTA M FERNANDEZ
Title or Position: OWNER
Credential: CPED
Phone: 727-585-4200