| NPI | 1538355250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH RODERIQUES Owner 941-497-3800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: FL POR 181) |
| Enumeration Date | 2007-09-16 |
| Last Update Date | 2019-06-20 |