Organization
FOOTWEAR BY DESIGN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAMELA ANN ECKENRODE L.C.PED (OWNER)
(407) 323-7441
Entity
Organization
Contact information
Practice address
1967 LONGWOOD LAKE MARY RD, SUITE 1001, LONGWOOD, FL 32750-4673
(407) 323-7441
(407) 323-1964
Mailing address
1967 LONGWOOD LAKE MARY RD, SUITE 1001, LONGWOOD, FL 32750-4673
(407) 323-7441
(407) 323-1964
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
PED154
FL
335E00000X
Prosthetic/Orthotic Supplier
PED154
FL
Other
Enumeration date
02/07/2007
Last updated
03/06/2009
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