MEDICARE: CERTIFIED ORTHOTICS AND PROSTHETICS INTERNATIONAL, INCORPORATED

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	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1689867269
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CERTIFIED ORTHOTICS AND PROSTHETICS INTERNATIONAL, INCORPORATED

Provider Business Mailing Address
First Line	:	950 W 41ST ST
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-3307
Country	:	US
Telephone Number	:	305-672-9393
Fax Number	:

Provider Business Practice Location Address
First Line	:	950 W 41ST ST
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-3307
Country	:	US
Telephone Number	:	305-672-9393
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR, VP
Name	:	MR. DAVID WALTER EDWARDS
Credential	:	CPO, ABC CERTIFIED
Telephone Number	:	305-672-9393

Provider Enumeration Date	:	08/27/2007
Last Update Date	:	08/27/2007

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