Provider Demographics
NPI:1033462171
Name:ABOUT YOU
Entity Type:Organization
Organization Name:ABOUT YOU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:SOKOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-891-1475
Mailing Address - Street 1:3401 HENDERSON BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-3988
Mailing Address - Country:US
Mailing Address - Phone:813-876-2727
Mailing Address - Fax:480-907-3092
Practice Address - Street 1:3401 HENDERSON BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-3989
Practice Address - Country:US
Practice Address - Phone:813-876-2727
Practice Address - Fax:813-876-2725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-25
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL000000000335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019334400Medicaid
AZ004431Medicaid