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General NPI Number Information
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NPI Number | 1902034317
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Entity Type | Organization
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Legal Business Name | TALLAHASSEE ORTHOPEDIC CLINIC III PL
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Dates
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Enumeration Date | 06/24/2009
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Last Update Date | 04/11/2023
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Provider Practice Location Address
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Address Line | 2011 HARRISON AVE
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City | PANAMA CITY
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State | FL
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Zip | 32405-4545
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Country | US
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Telephone | 850-691-4188
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Fax | 833-687-1451
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Provider Business Mailing Address
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Address Line | 3334 CAPITAL MEDICAL BLVD SUITE 400
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City | TALLAHASSEE
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State | FL
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Zip | 32308-8405
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Country | US
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Telephone | 850-877-8174
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Fax | 850-877-5636
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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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