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General NPI Number Information
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NPI Number | 1093930919
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Entity Type | Organization
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Legal Business Name | O&P ASSOCIATES OF CHARLOTTE CTY INC.
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 12/01/2008
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Provider Practice Location Address
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Address Line | 21216 OLEAN BLVD STE 1
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-6722
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Country | US
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Telephone | 941-629-9689
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Fax | 941-629-9693
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Provider Business Mailing Address
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Address Line | 21216 OLEAN BLVD STE 1
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-6722
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Country | US
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Telephone | 941-629-9689
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. JOHN G MARTIN
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Credential | LCPO
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Telephone | 941-629-9689
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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 | POR105
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License Number State | FL
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