Organization
MOBILE PROSTHETICS & ORTHOTICS, INC.
Active
Other names
Prosthetic & Orthotic Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STEPHANIE A KINGSTON (COO/ADMINISTRATOR)
(407) 245-7770
Entity
Organization
Contact information
Practice address
3160 SOUTHGATE COMMERCE BLVD, STE 38, ORLANDO, FL 32806-8549
(407) 245-7770
(407) 245-7727
Mailing address
3160 SOUTHGATE COMMERCE BLVD, STE 38, ORLANDO, FL 32806-8549
(407) 245-7770
(407) 245-7727
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104514
AVMED PROVIDER NUMBER
—
05
—
950862700
—
FL
Enumeration date
06/08/2005
Last updated
05/12/2020
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