Organization
ORTHOTIC & PROSTHETIC CLINIC OF JACKSONVILLE, LLC
Active
Other names
ORTHOTIC & PROSTHETIC CLINICS OF AMERICA
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAFAEL AGUSTIN DIAZ ABREU (OWNER / AMBR)
(305) 812-5087
Entity
Organization
Contact information
Practice address
11512 LAKE MEAD AVE UNIT 404, JACKSONVILLE, FL 32256-9687
(904) 231-8440
(904) 231-8441
Mailing address
2754 NW 27TH AVE, BOCA RATON, FL 33434-3692
(305) 812-5087
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
03/05/2024
Last updated
03/05/2024
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