EXPRESS ORTHOTICS & PROSTHETICS, INC. (NPI# 1396135315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1396135315 |
Entity Type | Organization |
Organization Name | EXPRESS ORTHOTICS & PROSTHETICS, INC. |
Practice Address |
3603 W Flora St Tampa FL 33614-4025 |
Practice Telephone | 8136054610 |
Practice Fax Number | 8136054612 |
Mailing Telephone | 8136054610 |
Mailing Fax Number | 8136054612 |
Enumeration Date | 2015-01-28 |
Last Update Date | 2015-07-27 |
Authorized Official Name | MR. SHANE EVANS WAKEFIELD (OWNER) |
Authorized Official Telephone | 8136054610 |
Authorized Official Credential | CPO/LPO |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 335E00000X | Prosthetic/Orthotic Supplier | POR249 | FL | Suppliers |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | EXPRESS ORTHOTICS & PROSTHETICS, INC. | 3603 W Flora St Ste 102, Tampa, FL 33614-4025 |
Street Address |
3603 W FLORA ST |
City | TAMPA |
State | FL |
Zip Code | 33614-4025 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134733082 | Robin Rollena Stewart | Home Health | 9537 Lazy Lane, Apt 302, Tampa, FL 33614 | 2020-09-08 |
1346885761 | David Joseph Page | Nurse Practitioner | St. Joseph's Behavioral Health Center, 4918 N. Habana Ave, Tampa, FL 33614 | 2019-11-08 |
1134687411 | Ramon Chang Adult Family Care Home LLC | Custodial Care Facility | 2607 W Humphrey St, Tampa, FL 33614 | 2019-03-06 |
1134600612 | Senior Point Assisted Living Facility, LLC | Assisted Living Facility | 2940 W Hillsborough Ave, Tampa, FL 33614 | 2018-08-23 |
1306361266 | Larry Valdes | Assisted Living Facility | 4402 W Minnehaha St, Tampa, FL 33614 | 2017-08-11 |
1982128062 | Jaime F Casellas Md Corp | Internal Medicine | 4600 N Habana Ave Suit #13, Tampa, FL 33614 | 2017-07-31 |
1891219119 | Waveney Gittens-williams | Alzheimer Center (Dementia Center) | 3706 W. Idle Wild Cir #203, Tampa, FL 33614 | 2017-07-28 |
1750811857 | Syerita Nicole Morris | Counselor | 6800 N Dale Marby Hwy, Ste 164, Tampa, FL 33614 | 2017-06-13 |
1447786124 | Lisa Moy | Case Manager/Care Coordinator | 4001 W. Dr. Martin Luther King Jr. Blvd., Tampa, FL 33614 | 2017-05-02 |
1750813804 | Joshua Martin Good | Physical Therapy Assistant | 3363 W. Waters Avenue, Suite 700, Tampa, FL 33614 | 2017-03-29 |
Find all providers in zip 33614 |
Taxonomy Code | 335E00000X |
Grouping | Suppliers |
Classification | Prosthetic/Orthotic Supplier |
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. |
Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831705805 | Fourroux Prosthetics, Inc | Prosthetic/Orthotic Supplier | 5453 N 59th St, Tampa, FL 33610-2011 | 2020-09-16 |
1013482546 | Westcoast Brace & Limb | Prosthetic/Orthotic Supplier | 4809 Memorial Hwy Ste C, Tampa, FL 33634-7515 | 2018-10-11 |
1700383312 | Gomez Orthotic Systems LLC | Prosthetic/Orthotic Supplier | 4809 Memorial Hwy, Tampa, FL 33634-7515 | 2018-04-10 |
1043767510 | Its Jazzy Salo | Prosthetic/Orthotic Supplier | 3010 N 22nd St, Tampa, FL 33605-1914 | 2016-09-01 |
1013462316 | Danori Inc. | Prosthetic/Orthotic Supplier | 1425 W Busch Blvd, Tampa, FL 33612-7601 | 2016-08-17 |
1922429588 | Amy Holm | Prosthetic/Orthotic Supplier | 812 W Mlk Blvd #100, Tampa, FL 33603-3338 | 2013-12-30 |
1033462171 | About You | Prosthetic/Orthotic Supplier | 3401 Henderson Blvd, Suite A, Tampa, FL 33609-3989 | 2012-10-25 |
1376858688 | American Ortho Tech Laboratories, Inc. | Prosthetic/Orthotic Supplier | 4809 Memorial Hwy Ste 100, Tampa, FL 33634-7515 | 2010-08-11 |
1740302645 | Italy Shoe Lab, Inc | Prosthetic/Orthotic Supplier | 9639 Palm River Rd, Tampa, FL 33619-4433 | 2007-04-04 |
1194733758 | Westcoast Brace & Limb | Prosthetic/Orthotic Supplier | 5311 E Fletcher Ave, Tampa, FL 33617-1147 | 2006-08-03 |
Find all providers in TAMPA |
Please comment or provide details below to improve the information on EXPRESS ORTHOTICS & PROSTHETICS, INC..
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.