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General NPI Number Information
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NPI Number | 1346428547
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Entity Type | Organization
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Legal Business Name | LIFE BACK ENTERPRISES, INC
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Dates
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Enumeration Date | 02/11/2008
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Last Update Date | 02/13/2012
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Provider Practice Location Address
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Address Line | 2506 SUCCESS DR
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City | ODESSA
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State | FL
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Zip | 33556-3400
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Country | US
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Telephone | 727-376-2003
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Fax | 727-376-4160
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Provider Business Mailing Address
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Address Line | 2506 SUCCESS DR
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City | ODESSA
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State | FL
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Zip | 33556-3400
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Country | US
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Telephone | 727-376-2003
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Fax | 727-376-4160
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Authorized Official
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Title or Position | OWNER/CEO
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Name | WILLIAM CAVALIERI SR.
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Credential |
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Telephone | 727-376-2003
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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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