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Organization

ORTHOQUIP, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DEBRA GROENEVELD (PRESIDENT)
(954) 650-2263
Entity
Organization

Contact information

Practice address
4022 N OCEAN BLVD, FT LAUDERDALE, FL 33308-6420
(954) 650-2263
Mailing address
4710 NE 25TH AVE, FT LAUDERDALE, FL 33308-4811
(954) 650-2263

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
ORF12
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ORF13
ORTHOTIC FITTER LICENSE
FL
Enumeration date
07/19/2010
Last updated
07/19/2010
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