# ROCKET ORTHOTICS & SUPPLY CORP

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

## Provider details

- **NPI number:** 1538823703
- **Authorized official:** REZILTA REHABILITATION SERVICES (REGISTERED AGENT)
- **Authorized official phone:** (786) 233-9283

## Contact information

- **Practice address:** 1926 HOLLYWOOD BLVD \# 304-128, HOLLYWOOD, FL 33020-4532
- **Practice address phone:** (561) 247-5577
- **Mailing address:** 1926 HOLLYWOOD BLVD \# 304-128, HOLLYWOOD, FL 33020-4532

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 224L00000X | Pedorthist | — | NULL | — |
| 224L00000X | Pedorthist | — | — | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |
| 335E00000X | Prosthetic/Orthotic Supplier | — | NULL | — |

## Other

- **Enumeration date:** 10/25/2021
- **Last updated:** 09/29/2023