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General NPI Number Information
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NPI Number | 1306376355
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Entity Type | Organization
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Legal Business Name | ORTHOTICS CENTER INC.
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Dates
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Enumeration Date | 06/13/2017
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Last Update Date | 06/13/2017
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Provider Practice Location Address
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Address Line | 1405 S ORANGE AVE STE 308
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City | ORLANDO
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State | FL
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Zip | 32806-2147
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Country | US
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Telephone | 407-757-2460
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Fax | 407-757-2632
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Provider Business Mailing Address
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Address Line | 14331 SW 120TH ST STE 212
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City | MIAMI
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State | FL
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Zip | 33186-7297
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Country | US
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Telephone | 305-640-5966
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Fax | 305-640-5027
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Authorized Official
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Title or Position | PRESIDENT
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Name | NADIA ISMAEL
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Credential |
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Telephone | 305-640-5966
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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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