| NPI | 1740302645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY JAMES CORNIELLO Pedorthist 813-645-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: FL PED 76) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2020-08-22 |