Provider Demographics
NPI:1922335132
Name:NORPRO PROSTHETICS & ORTHOTICS, INC
Entity Type:Organization
Organization Name:NORPRO PROSTHETICS & ORTHOTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:MATTHAEI
Authorized Official - Suffix:
Authorized Official - Credentials:FLP & O, CP
Authorized Official - Phone:561-627-7727
Mailing Address - Street 1:4431 WESTROADS DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-1207
Mailing Address - Country:US
Mailing Address - Phone:561-627-7727
Mailing Address - Fax:
Practice Address - Street 1:2205 S 25TH ST
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950
Practice Address - Country:US
Practice Address - Phone:772-618-2830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-09
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL950605500Medicaid
0644080012Medicare NSC