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General NPI Number Information
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NPI Number | 1790032498
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Entity Type | Organization
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Legal Business Name | PROSTHETICS AND ORTHOTICS OF FLORIDA
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Dates
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Enumeration Date | 08/13/2012
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Last Update Date | 08/13/2012
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Provider Practice Location Address
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Address Line | 10875 PARK BLVD STE B2
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City | SEMINOLE
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State | FL
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Zip | 33772-5456
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Country | US
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Telephone | 727-224-5076
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Fax |
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Provider Business Mailing Address
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Address Line | 10875 PARK BLVD STE B2
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City | SEMINOLE
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State | FL
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Zip | 33772-5456
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Country | US
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Telephone | 727-224-5076
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CARY FROUNFELTER
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Credential |
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Telephone | 727-224-5706
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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 | POR175
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License Number State | FL
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