Organization
BADER PROSTHETICS & ORTHOTICS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WADE BADER CPO (PRESIDENT)
(813) 962-6100
Entity
Organization
Contact information
Practice address
125 CHAPMAN RD E, LUTZ, FL 33549-8106
(813) 962-6100
Mailing address
125 CHAPMAN RD E, LUTZ, FL 33549-8106
(813) 962-6100
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
POR53
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
218107
AMERIGROUP
FL
01
—
M2130
BLUE CROSS BLUE SHIELD #
FL
Enumeration date
05/23/2005
Last updated
04/01/2008
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