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General NPI Number Information
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NPI Number | 1093746497
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Entity Type | Organization
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Legal Business Name | FLORIDA O & P SERVICES INC
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 08/12/2020
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Provider Practice Location Address
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Address Line | 1797 OLD MOULTRIE RD SUITE 110
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City | ST AUGUSTINE
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State | FL
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Zip | 32084-4171
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Country | US
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Telephone | 904-826-0027
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Fax | 904-808-9973
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Provider Business Mailing Address
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Address Line | 3636 UNIVERSITY BLVD S SUITE B10
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City | JACKSONVILLE
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State | FL
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Zip | 32216-4250
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Country | US
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Telephone | 904-737-7755
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Fax | 904-737-7962
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MATTHEW PRIESTLY BAILEY
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Credential | C.P.O
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Telephone | 904-737-7755
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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 | POR46
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License Number State | FL
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