ITALY SHOE LAB, INC (NPI# 1962455873) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1962455873 |
Entity Type | Organization |
Organization Name | ITALY SHOE LAB, INC |
Practice Address |
16621 Hwy 301 S #107 Wimauma FL 33598 |
Mailing Address |
13521 Mango Bay Dr Riverview FL 33579-2336 |
Practice Telephone | 8136455800 |
Practice Fax Number | 8136410319 |
Mailing Telephone | 8136455800 |
Enumeration Date | 2006-05-19 |
Last Update Date | 2008-02-27 |
Authorized Official Name | JEFFREY M CORNIELLO (VICE-PRESIDENT) |
Authorized Official Telephone | 8136455800 |
Authorized Official Credential | CPED |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 335E00000X | Prosthetic/Orthotic Supplier | NO PED 76 | FL | Suppliers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740302645 | Italy Shoe Lab, Inc | Prosthetic/Orthotic Supplier | 9639 Palm River Rd, Tampa, FL 33619-4433 | 2007-04-04 |
Street Address |
16621 HWY 301 S #107 |
City | WIMAUMA |
State | FL |
Zip Code | 33598 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962032672 | Micheline Renee Ferguson | Case Manager/Care Coordinator | 10008 Carloway Hills Dr., Wimauma, FL 33598 | 2020-01-22 |
1619468840 | Community & Home Health Solutions Inc | Registered Nurse | 15703 Carlton Lake Rd., Wimauma, FL 33598 | 2018-05-23 |
1629368949 | Marcus William Campbell | Pharmacist | Tgmg Sun City Center, 16521 South Us Hwy 301, Wimauma, FL 33598 | 2011-04-08 |
1184934895 | Edith Berrien Homehealth Service | Home Health | 6011 Vel Street, Wimauma, FL 33598 | 2010-10-15 |
1962637488 | Christina Ann Raymond | Mechanotherapist | 1078 Chert Rock Trl, Wimauma, FL 33598 | 2009-05-28 |
1922139344 | Wal-mart Stores East, L.p. | Technician/Technologist | 4928 State Rd. 674, Ruskin, FL 33598 | 2007-03-08 |
1275071581 | Landez Thomas | Behavior Technician | 10722 Standing Stone Dr, Wimauma, FL 33598 | 2017-02-07 |
1407413974 | Synergic Healthcare Solutions LLC | Clinic/Center | 16521 S Us Highway 301, Wimauma, FL 33598-2032 | 2019-05-21 |
1881161826 | Tower Imaging LLC | Radiology | 16521 S. Us Hwy 301, Wimauma, FL 33598-2032 | 2018-10-29 |
1316364623 | Jonathan Pavlinec | Urology | 16513 S Us Highway 301, Wimauma, FL 33598-2032 | 2014-03-25 |
Find all providers in zip 33598 |
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 |
---|---|---|---|---|
1073120192 | Solaris Ortho, LLC | Prosthetic/Orthotic Supplier | 1112 W Shell Point Rd Ste 304, Ruskin, FL 33570-3400 | 2020-09-24 |
1467068635 | Laquavian Eliacin | Prosthetic/Orthotic Supplier | 1738 Se Port St Lucie Blvd, Port St Lucie, FL 34952-5467 | 2020-09-22 |
1831705805 | Fourroux Prosthetics, Inc | Prosthetic/Orthotic Supplier | 5453 N 59th St, Tampa, FL 33610-2011 | 2020-09-16 |
1790397875 | Gessy Rigaud | Prosthetic/Orthotic Supplier | 5100 Sw 41st St Apt 115, Hollywood, FL 33023-6988 | 2020-08-19 |
1609486737 | Beauty Vault Lux LLC. | Prosthetic/Orthotic Supplier | 5100 Sw 41st St, Hollywood, FL 33023-6948 | 2020-08-04 |
1003424680 | Spartan Capital Investments | Prosthetic/Orthotic Supplier | 1621 E Edgewood Dr Ste B, Lakeland, FL 33803-3365 | 2020-07-20 |
1518583012 | Ts&a Medical Supply LLC | Prosthetic/Orthotic Supplier | 13555 Automobile Blvd Ste 650, Clearwater, FL 33762-3854 | 2020-06-19 |
1962027128 | Qbc Durable Medical Equipment | Prosthetic/Orthotic Supplier | 931 Village Blvd # 256, West Palm Beach, FL 33409-1803 | 2020-06-13 |
1083239891 | K.n. Medical Wigs Inc | Prosthetic/Orthotic Supplier | 651 E Main St Ste I, Haines City, FL 33844-4240 | 2020-06-08 |
1730703851 | Mahnke's Orthotics & Prosthetics of Deerfield Inc | Prosthetic/Orthotic Supplier | 4208 N 31st Ave Ste 2, Hollywood, FL 33021-2002 | 2020-06-04 |
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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.