Healthcare Provider Details

I. General information

NPI: 1396790804
Provider Name (Legal Business Name): FLORIDA PROSTHETICS & ORTHOTICS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9740 SW 40TH ST UNIT 4
MIAMI FL
33165
US

IV. Provider business mailing address

9740 SW 40TH ST., UNIT 4
MIAMI FL
33165
US

V. Phone/Fax

Practice location:
  • Phone: 305-553-1217
  • Fax: 305-553-1237
Mailing address:
  • Phone: 305-553-1217
  • Fax: 305-553-1237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberPOR75
License Number StateFL

VIII. Authorized Official

Name: MR. ROLANDO TORRES
Title or Position: PRESIDENT/PROTHETIST, ORTHOTIST
Credential: C.P.O.
Phone: 305-553-1217