# PENINSULA ORTHOTICS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275906653
- **Authorized official:** MR. BRUCE L NEWMAN (OWNER)
- **Authorized official phone:** (561) 502-4466

## Contact information

- **Practice address:** 6131 LAKE WORTH RD, GREENACRES, FL 33463-3048
- **Practice address phone:** (561) 502-4466
- **Mailing address:** 6131 LAKE WORTH RD, GREENACRES, FL 33463-3048
- **Mailing address phone:** (561) 502-4466

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | PED56 | FL | Yes |
| 335E00000X | Prosthetic/Orthotic Supplier | PED56 | FL | — |

## Other

- **Enumeration date:** 11/05/2015
- **Last updated:** 11/05/2015