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General NPI Number Information
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NPI Number | 1649274556
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Entity Type | Organization
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Legal Business Name | MOBILE PROSTHETICS & ORTHOTICS, INC.
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Dates
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Enumeration Date | 06/08/2005
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Last Update Date | 05/12/2020
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Provider Practice Location Address
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Address Line | 3160 SOUTHGATE COMMERCE BLVD STE 38
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City | ORLANDO
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State | FL
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Zip | 32806-8549
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Country | US
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Telephone | 407-245-7770
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Fax | 407-245-7727
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Provider Business Mailing Address
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Address Line | 3160 SOUTHGATE COMMERCE BLVD STE 38
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City | ORLANDO
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State | FL
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Zip | 32806-8549
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Country | US
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Telephone | 407-245-7770
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Fax | 407-245-7727
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Authorized Official
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Title or Position | COO/ADMINISTRATOR
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Name | MS. STEPHANIE A KINGSTON
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Credential |
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Telephone | 407-245-7770
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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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