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General NPI Number Information
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NPI Number | 1881119774
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Entity Type | Organization
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Legal Business Name | NATIONAL ORTHOTICS LLC
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Dates
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Enumeration Date | 08/11/2017
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Last Update Date | 08/11/2017
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Provider Practice Location Address
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Address Line | 7208 W SAND LAKE RD STE 305
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City | ORLANDO
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State | FL
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Zip | 32819-5279
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Country | US
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Telephone | 407-362-1825
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Fax | 407-413-5498
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Provider Business Mailing Address
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Address Line | 8137 CHILTON DR
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City | ORLANDO
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State | FL
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Zip | 32836-5900
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Country | US
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Telephone | 407-367-9149
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM NOVACK
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Credential |
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Telephone | 407-367-9149
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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 | 3100-1187041
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License Number State | FL
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