Organization
NLS FAMILY ENTERPRISE, INC.
Active
Other names
Foot Solutions
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NARENDRA SREERAM CPED (PRESIDENT)
(904) 646-4640
Entity
Organization
Contact information
Practice address
4372 SOUTHSIDE BLVD, SUITE 303, JACKSONVILLE, FL 32216-8501
(904) 646-4640
(904) 646-4631
Mailing address
4372 SOUTHSIDE BLVD, SUITE 303, JACKSONVILLE, FL 32216-8501
(904) 646-4640
(904) 646-4631
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
PED 94
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M2790
BLUE CROSS BLUESHIELD
FL
Enumeration date
12/05/2006
Last updated
04/20/2008
Update your record
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