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	HCC4459	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
2	1683602	OTHER	FL	CIGNA
3	2331574	OTHER	FL	AETNA HMO
4	M2505	OTHER	FL	BCBS FL
5	82-80128	OTHER	FL	ACM
6	51086	OTHER	FL	BCBS MI
7	9107700300	OTHER	FL	ACESS HEALTH SOLUTIONS
8	008192	OTHER	FL	FL HEALTHCARE
9	145048	OTHER	FL	STAYWELL, WELLCARE, HEALT
10	51086	OTHER	FL	ABP
11	211935	OTHER	FL	AMERIGROUP
12	50135	OTHER	FL	FOUNDATION
13	000006879	OTHER	FL	BEECH STREET
14	276554	OTHER	FL	AVMED
15	5688143	OTHER	FL	AETNA PPO

General Provider Information

NPI Number	:	1639276066
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	:	2763 W OLD US HWY 441
Second Line	:
City	:	MOUNT DORA
State	:	FL
Zip	:	32757-3500
Country	:	US
Telephone Number	:	800-330-8881
Fax Number	:	800-261-9537

Authorized Official
Title or Position	:	DIRECTOR OF REIMBURSEMENT
Name	:	MR. SHERYL S PRICE
Credential	:
Telephone Number	:	503-493-8288

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	05/01/2014

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