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General NPI Number Information
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NPI Number | 1003427063
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Entity Type | Organization
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Legal Business Name | ABC PROSTHETICS & ORTHOTICS OF NORTH FLORIDA
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Dates
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Enumeration Date | 08/13/2020
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Last Update Date | 08/13/2020
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Provider Practice Location Address
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Address Line | 6817 SOUTHPOINT PKWY
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City | JACKSONVILLE
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State | FL
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Zip | 32216-6282
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Country | US
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Telephone | 904-686-8222
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Fax | 904-686-8224
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Provider Business Mailing Address
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Address Line | 6817 SOUTHPOINT PKWY
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City | JACKSONVILLE
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State | FL
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Zip | 32216-6282
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Country | US
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Telephone | 904-686-8222
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Fax | 904-686-8224
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | FERN ROSS
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Credential |
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Telephone | 407-999-8977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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