Organization
INNOVATIVE ORTHOTICS & PROSTHETICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREW D DOMB CPO (OWNER)
(561) 296-2000
Entity
Organization
Contact information
Practice address
537 US HIGHWAY 1, SUITE 6, NORTH PALM BEACH, FL 33408-4903
(561) 296-2000
(561) 296-9912
Mailing address
537 US HIGHWAY 1, SUITE 6, NORTH PALM BEACH, FL 33408-4903
(561) 296-2000
(561) 296-9912
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
POR188
FL
224P00000X
Prosthetist
Primary
POR188
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032644500
—
FL
01
—
M2829
BCBSFL
FL
Enumeration date
06/29/2007
Last updated
08/02/2010
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