Organization
ORTHOMEDX CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN A FRALEY (PRESIDENT/OWNER)
(407) 422-4526
Entity
Organization
Contact information
Practice address
4629 36TH ST STE 800, ORLANDO, FL 32811
(407) 422-4526
(407) 422-4556
Mailing address
4629 36TH ST STE 800, ORLANDO, FL 32811-6511
(407) 422-4526
(407) 422-4556
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
BUS0024240-001
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R8401
BC BS PROVIDER NUMBER
FL
Enumeration date
11/27/2006
Last updated
06/10/2019
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