Provider Demographics
NPI:1003336538
Name:GG ORTHOTICS LLC
Entity Type:Organization
Organization Name:GG ORTHOTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KOCHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-387-4389
Mailing Address - Street 1:1005 NE 125TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-5850
Mailing Address - Country:US
Mailing Address - Phone:833-387-4389
Mailing Address - Fax:
Practice Address - Street 1:1005 NE 125TH ST STE 101
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-5850
Practice Address - Country:US
Practice Address - Phone:833-387-4389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies