Organization
IMPLAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KELLY ALAN POWERS (PRESIDENT)
(941) 907-8263
Entity
Organization
Contact information
Practice address
6151 LAKE OSPREY DR, 3RD FLOOR, SARASOTA, FL 34240-8419
(866) 526-8412
(866) 526-8413
Mailing address
6151 LAKE OSPREY DR, 3RD FLOOR, SARASOTA, FL 34240-8419
(866) 526-8412
(866) 526-8413
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
FL
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
02/04/2009
Last updated
02/04/2009
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