MEDICARE: ADVANCED PROSTHETICS OF AMERICA INC

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
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	335E00000X	Prosthetic/Orthotic Supplier	HCC4460	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407945546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED PROSTHETICS OF AMERICA INC

Provider Business Mailing Address
First Line	:	PO BOX 650846
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75265-0846
Country	:	US
Telephone Number	:	800-330-8881
Fax Number	:	800-261-9537

Provider Business Practice Location Address
First Line	:	123 S INDUSTRIAL DR
Second Line	:	SUITE 104
City	:	ORANGE CITY
State	:	FL
Zip	:	32763-7421
Country	:	US
Telephone Number	:	386-775-2800
Fax Number	:	386-775-8999

Authorized Official
Title or Position	:	CEO
Name	:	MR. ROD FRIEDLAND
Credential	:
Telephone Number	:	800-330-8881

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	05/09/2014

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Directions to “ADVANCED PROSTHETICS OF AMERICA INC ” Practice Location

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