Organization
M & M REHAB INC
Active
Other names
MID-FLORIDA PROSTHETICS & ORTHOTICS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VICTOR BUSTAMANTE CPO (PRESIDENT)
(352) 331-3399
Entity
Organization
Contact information
Practice address
2300 SE 17TH ST, SUITE 401, OCALA, FL 34471-9107
(352) 351-3207
(352) 351-3267
Mailing address
2300 SE 17TH ST, SUITE 401, OCALA, FL 34471-9107
(352) 351-3207
(352) 351-3267
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
POR89
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021846400
—
FL
01
—
M0794
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/29/2009
Last updated
08/07/2020
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