Organization
BAYSIDE ORTHOTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEROD ROMANIK (MGR)
(954) 778-4615
Entity
Organization
Contact information
Practice address
11671 W COQUINA CT, CRYSTAL RIVER, FL 34429-9222
(954) 778-4615
Mailing address
11671 W COQUINA CT, CRYSTAL RIVER, FL 34429-9222
(954) 778-4615
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/04/2017
Last updated
05/04/2017
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