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General NPI Number Information
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NPI Number | 1508691056
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Entity Type | Organization
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Legal Business Name | TALLAHASSEE ORTHOPEDIC CLINIC III, P.L.
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Dates
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Enumeration Date | 09/04/2024
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 8839 BRYAN DAIRY RD STE 240B
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City | LARGO
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State | FL
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Zip | 33777-1203
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Country | US
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Telephone | 813-978-9700
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Fax |
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Provider Business Mailing Address
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Address Line | 13020 N TELECOM PKWY
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City | TEMPLE TERRACE
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State | FL
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Zip | 33637-0915
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BUSINESS OFFICE DIRECTOR
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Name | LORI J CARTER
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Credential |
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Telephone | 850-219-1925
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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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Taxonomy #2
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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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