Provider Demographics
NPI:1033397476
Name:LOMBARDOCOMFORT&CASUALSHOESINC
Entity Type:Organization
Organization Name:LOMBARDOCOMFORT&CASUALSHOESINC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GIUSEPPE
Authorized Official - Middle Name:P
Authorized Official - Last Name:LOMBARDO
Authorized Official - Suffix:
Authorized Official - Credentials:OST,CPED
Authorized Official - Phone:352-854-2292
Mailing Address - Street 1:8530 SW HIGHWAY 200
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34481-2100
Mailing Address - Country:US
Mailing Address - Phone:352-854-2292
Mailing Address - Fax:
Practice Address - Street 1:8530 SW HIGHWAY 200
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481-2100
Practice Address - Country:US
Practice Address - Phone:352-854-2292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPED 7335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5068580001Medicare NSC