| NPI | 1679801914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAD A GALLO President Of Manager 941-493-4049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: FL POR - 014) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: FL POR - 006) |
| Enumeration Date | 2009-11-25 |
| Last Update Date | 2010-10-12 |