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NPI 1285881839

NPI 1285881839 : FLORIDA ORTHOPEDIC SYSTEMS : RIVERVIEW, FL

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General NPI Number Information
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    NPI Number           |    1285881839
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    Entity Type          |    Organization 
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    Legal Business Name  |    FLORIDA ORTHOPEDIC SYSTEMS 
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Dates
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    Enumeration Date     |    08/26/2008
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    Last Update Date     |    08/26/2008
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Provider Practice Location Address
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    Address Line         |    10434 FLY FISHING ST 
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    City                 |    RIVERVIEW
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    State                |    FL
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    Zip                  |    33569-2734
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    Country              |    US
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    Telephone            |    813-765-5689
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    10434 FLY FISHING ST 
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    City                 |    RIVERVIEW
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    State                |    FL
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    Zip                  |    33569-2734
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    Country              |    US
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    Telephone            |    813-765-5689
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    Fax                  |    
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |     STEVEN J HICKS 
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    Credential           |    
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    Telephone            |    813-765-5689
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    332B00000X
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    Taxonomy Name        |    Durable Medical Equipment & Medical Supplies
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    License Number       |    
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    License Number State |    
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