Organization
ADVANCED DIABETIC SHOES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARLENE OBRIEN (OWNER)
(727) 942-9085
Entity
Organization
Contact information
Practice address
38511 US 19 N, PALM HARBOR, FL 34684-1033
(727) 942-9085
(727) 945-1925
Mailing address
PO BOX 965, TARPON SPRINGS, FL 34688-0965
(727) 942-9085
(727) 945-1925
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R9692
BC/BS
FL
Enumeration date
08/03/2006
Last updated
04/20/2008
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