Organization
PENINSULA ORTHOTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE L NEWMAN (OWNER)
(561) 502-4466
Entity
Organization
Contact information
Practice address
6131 LAKE WORTH RD, GREENACRES, FL 33463-3048
(561) 502-4466
Mailing address
6131 LAKE WORTH RD, GREENACRES, FL 33463-3048
(561) 502-4466
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
PED56
FL
335E00000X
Prosthetic/Orthotic Supplier
PED56
FL
Other
Enumeration date
11/05/2015
Last updated
11/05/2015
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