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General NPI Number Information
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NPI Number | 1871775668
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Entity Type | Organization
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Legal Business Name | O & P CLINICAL TECHNOLOGIES, INC.
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Dates
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Enumeration Date | 12/03/2007
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 4650 NW 39TH AVE STE G
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City | GAINESVILLE
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State | FL
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Zip | 32606-6090
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Country | US
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Telephone | 352-331-4221
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Fax | 352-332-8074
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Provider Business Mailing Address
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Address Line | 4650 NW 39TH AVE STE G
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City | GAINESVILLE
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State | FL
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Zip | 32606-6090
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Country | US
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Telephone | 352-331-4221
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Fax | 352-332-8074
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | PAUL E. PRUSAKOWSKI
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Credential | LPO, CPO, FAAOP
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Telephone | 352-331-4221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | POR56
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | POR56
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License Number State | FL
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