Provider Demographics
NPI:1508674631
Name:ORTHOPAEDIC TOI LLC
Entity type:Organization
Organization Name:ORTHOPAEDIC TOI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:RODRIGUEZ LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-751-0223
Mailing Address - Street 1:PO BOX 701795
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34770-1795
Mailing Address - Country:US
Mailing Address - Phone:407-751-0223
Mailing Address - Fax:
Practice Address - Street 1:5438 PINE LILLY DR
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34771-0120
Practice Address - Country:US
Practice Address - Phone:407-751-0223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHOPAEDIC TOI LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter
No335E00000XSuppliersProsthetic/Orthotic Supplier