Provider Demographics
NPI:1477594224
Name:SAUNDERS PROSTHETICS & ORTHOTICS INC.
Entity Type:Organization
Organization Name:SAUNDERS PROSTHETICS & ORTHOTICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SAUNDERS
Authorized Official - Suffix:
Authorized Official - Credentials:CPO, LPO
Authorized Official - Phone:352-259-9749
Mailing Address - Street 1:25 LAGRANDE BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:LADY LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:32159-2385
Mailing Address - Country:US
Mailing Address - Phone:352-259-9749
Mailing Address - Fax:352-259-8209
Practice Address - Street 1:25 LAGRANDE BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-2385
Practice Address - Country:US
Practice Address - Phone:352-259-9749
Practice Address - Fax:352-259-8209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPOR7335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5027390001Medicare ID - Type UnspecifiedLOCATION 2