Provider Demographics
NPI:1588837371
Name:SAUNDERS PROSTHETICS & ORTHOTICS GROUP, LLC
Entity Type:Organization
Organization Name:SAUNDERS PROSTHETICS & ORTHOTICS GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:R
Authorized Official - Last Name:SAUNDERS
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:352-259-9749
Mailing Address - Street 1:761 COUNTY ROAD 466
Mailing Address - Street 2:
Mailing Address - City:LADY LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:32159-6340
Mailing Address - Country:US
Mailing Address - Phone:352-259-9749
Mailing Address - Fax:352-259-8209
Practice Address - Street 1:761 COUNTY ROAD 466
Practice Address - Street 2:
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-6340
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:2008-04-11
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPOR40335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
6127360001Medicare NSC