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General NPI Number Information
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NPI Number | 1447441449
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Entity Type | Organization
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Legal Business Name | TAMPA BAY BRACE AND LIMB INC
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 516 LAKEVIEW RD VILLA1
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City | CLEARWATER
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State | FL
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Zip | 33756-9999
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Country | US
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Telephone | 727-449-9292
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Fax | 727-449-9393
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Provider Business Mailing Address
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Address Line | 516 LAKEVIEW RD
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City | CLEARWATER
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State | FL
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Zip | 33756-3302
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Country | US
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Telephone | 727-449-9292
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LORI BAILEY
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Credential |
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Telephone | 727-449-9292
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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 | POR161
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License Number State | FL
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