Provider Demographics
NPI:1912913377
Name:CDSS CORPORATION
Entity Type:Organization
Organization Name:CDSS CORPORATION
Other - Org Name:FOOT SOLUTIONS ORLANDO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KLECZKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-897-3209
Mailing Address - Street 1:3122 E COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-5175
Mailing Address - Country:US
Mailing Address - Phone:407-897-3209
Mailing Address - Fax:407-898-5813
Practice Address - Street 1:3122 E COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5175
Practice Address - Country:US
Practice Address - Phone:407-897-3209
Practice Address - Fax:407-898-5813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5734160001Medicare NSC