Organization
MOONLIGHT ORTHOTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VLADIMIR DE LA HOZ (CEO/PRESIDENT)
(954) 516-0850
Entity
Organization
Contact information
Practice address
1926 HOLLYWOOD BLVD STE 301, HOLLYWOOD, FL 33020-4543
(954) 516-0850
(954) 516-0870
Mailing address
1926 HOLLYWOOD BLVD STE 301, HOLLYWOOD, FL 33020-4543
(954) 516-0850
(954) 516-0870
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/21/2022
Last updated
06/22/2022
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