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NPI Code Detail

MEDICARE: UNITED PROSTHETICS AND ORTHOTICS

MEDICARE: UNITED PROSTHETICS AND ORTHOTICS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224P00000XProsthetist511AL

General Provider Information

NPI Number : 1164758785
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNITED PROSTHETICS AND ORTHOTICS
Provider Business Mailing Address
First Line : PO BOX 56886
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32241-6886
Country : US
Telephone Number : 904-638-9686
Fax Number :
Provider Business Practice Location Address
First Line : 9759 SAN JOSE BLVD STE 2
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32257-5418
Country : US
Telephone Number : 904-638-9686
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MR. REGINALD A. MAYS
Credential :
Telephone Number : 904-444-3970
Provider Enumeration Date : 11/02/2009
Last Update Date : 03/18/2010

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Directions to “UNITED PROSTHETICS AND ORTHOTICS ” Practice Location

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