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Intercoastal Orthotics & Prosthetics, Llc
Prosthetic/Orthotic Supplier in Edgewater, Florida
NPI 1083839062

Intercoastal Orthotics & Prosthetics, Llc is a Prosthetic/Orthotic Supplier based in Edgewater, FL. Intercoastal Orthotics & Prosthetics, Llc practices in Edgewater, FL. The NPI Number for Intercoastal Orthotics & Prosthetics, Llc is 1083839062 and holds a License No. POR 162 (Florida).

The current practice location address for Intercoastal Orthotics & Prosthetics, Llc is 1 Pelican Dr Ste A, Edgewater, FL and can be reached out via phone at 386-409-9432 and via fax at 386-409-9433.

Location: 1 Pelican Dr Ste A, Edgewater, FL, 32141-4254
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1083839062
Provider Name
Intercoastal Orthotics & Prosthetics, Llc
Credential
Provider Entity Type
Organization
Address
1 Pelican Dr Ste A, Edgewater, FL, 32141-4254
Phone Number
386-409-9432
Fax Number
386-409-9433
Provider Enumeration Date
04/16/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
M2714 01 FL BLUE CROSS PROVIDER #
institution
Provider Business Practice Location Address Details
Address
1 Pelican Dr Ste A
City
Edgewater
State
Florida
Zip
32141-4254
Phone Number
386-409-9432
Fax Number
386-409-9433
person
Provider Business Mailing Address Details
Address
1 Pelican Dr Ste A
City
Edgewater
State
Florida
Zip
32141-4254
Phone Number
386-409-9432
Fax Number
386-409-9433
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
POR 162 (Florida)
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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