Provider Demographics
NPI:1528185659
Name:JUSTARI HOLDINGS, INC.
Entity Type:Organization
Organization Name:JUSTARI HOLDINGS, INC.
Other - Org Name:FOOT SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:FELDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CPED
Authorized Official - Phone:954-474-0416
Mailing Address - Street 1:8277 W SUNRISE BLVD
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-5403
Mailing Address - Country:US
Mailing Address - Phone:954-474-0416
Mailing Address - Fax:954-474-0693
Practice Address - Street 1:8277 W SUNRISE BLVD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-5403
Practice Address - Country:US
Practice Address - Phone:954-474-0416
Practice Address - Fax:954-474-0693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5955130001Medicare NSC