Healthcare Provider Details

I. General information

NPI: 1609256528
Provider Name (Legal Business Name): K4 OUTCOMES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2015
Last Update Date: 04/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 CYPRESS WAY E SUITE 60
NAPLES FL
34110-9275
US

IV. Provider business mailing address

PO BOX 110808
NAPLES FL
34108-0114
US

V. Phone/Fax

Practice location:
  • Phone: 239-307-5520
  • Fax:
Mailing address:
  • Phone: 239-307-5520
  • Fax:

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: MR. RICHARD GINGRAS
Title or Position: PRESIDENT
Credential:
Phone: 336-414-5828