Provider Demographics
NPI:1831627462
Name:SKY ORTHOTICS & PROSTHETICS LLC
Entity type:Organization
Organization Name:SKY ORTHOTICS & PROSTHETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C0O
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWMYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-362-7944
Mailing Address - Street 1:1009 MAITLAND CENTER COMMONS BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7270
Mailing Address - Country:US
Mailing Address - Phone:844-759-5462
Mailing Address - Fax:888-653-3429
Practice Address - Street 1:1009 MAITLAND CENTER COMMONS BLVD STE 207
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-7270
Practice Address - Country:US
Practice Address - Phone:844-759-5462
Practice Address - Fax:888-653-3429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier