Provider Demographics
NPI:1881119774
Name:NATIONAL ORTHOTICS LLC
Entity type:Organization
Organization Name:NATIONAL ORTHOTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-367-9149
Mailing Address - Street 1:8137 CHILTON DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836-5900
Mailing Address - Country:US
Mailing Address - Phone:407-367-9149
Mailing Address - Fax:
Practice Address - Street 1:7208 W SAND LAKE RD STE 305
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-5279
Practice Address - Country:US
Practice Address - Phone:407-362-1825
Practice Address - Fax:407-413-5498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-11
Last Update Date:2017-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3100-1187041332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment