Provider Demographics
NPI:1689867269
Name:CERTIFIED ORTHOTICS AND PROSTHETICS INTERNATIONAL, INCORPORATED
Entity type:Organization
Organization Name:CERTIFIED ORTHOTICS AND PROSTHETICS INTERNATIONAL, INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, VP
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:CPO, ABC CERTIFIED
Authorized Official - Phone:305-672-9393
Mailing Address - Street 1:950 W 41ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3307
Mailing Address - Country:US
Mailing Address - Phone:305-672-9393
Mailing Address - Fax:
Practice Address - Street 1:950 W 41ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3307
Practice Address - Country:US
Practice Address - Phone:305-672-9393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier