Organization
TAMPA BAY ARTIFICIAL LIMBS, INC.
Active
Other names
Manifest Prosthetics & Orthotics
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA PAULA GOMEZ CPO (CEO)
(813) 801-9110
Entity
Organization
Contact information
Practice address
5109 N ARMENIA AVE, TAMPA, FL 33603-1405
(813) 801-9110
(813) 801-9048
Mailing address
5109 N ARMENIA AVE, TAMPA, FL 33603-1405
(813) 801-9110
(813) 801-9048
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
PRO 25
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120716100
—
FL
01
—
290808
STAYWELL
FL
01
—
7376145
AETNA EPDB PIN #
FL
01
—
R9100
BLUE CROSS BLUE SHIELD FL
FL
01
—
V516P-7063
TAMPA VA VENDOR #
FL
Enumeration date
06/21/2006
Last updated
04/08/2026
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