Provider Demographics
NPI:1508336777
Name:USA ORTHOTICS PROSTHETICS & ASSOCIATES INC
Entity Type:Organization
Organization Name:USA ORTHOTICS PROSTHETICS & ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-994-5596
Mailing Address - Street 1:203 S. CLYDE AVENUE
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741
Mailing Address - Country:US
Mailing Address - Phone:407-994-5596
Mailing Address - Fax:407-286-4515
Practice Address - Street 1:932 E OSCEOLA PKWY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-1615
Practice Address - Country:US
Practice Address - Phone:407-994-5596
Practice Address - Fax:407-286-4515
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:USA ORTHODICS PROSTHESICS & ASSOCIATE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-30
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier