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General NPI Number Information
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NPI Number | 1174526396
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Entity Type | Organization
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Legal Business Name | SONLIFE PROSTHETICS & ORTHOTICS, INC.
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 03/19/2010
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Provider Practice Location Address
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Address Line | 6111 DELTONA BLVD
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City | SPRING HILL
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State | FL
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Zip | 34606-1011
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Country | US
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Telephone | 352-596-2257
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Fax | 352-596-0180
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Provider Business Mailing Address
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Address Line | 6111 DELTONA BLVD
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City | SPRING HILL
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State | FL
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Zip | 34606-1011
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Country | US
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Telephone | 352-596-2257
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Fax | 352-596-0180
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DAVID S. GORIS
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Credential | LPO
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Telephone | 352-596-2257
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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 | POR 16
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License Number State | FL
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