MID-FLORIDA PROSTHETICS & ORTHOTICS (M & M REHAB INC) NPI 1003022351

Prosthetic/Orthotic Supplier in Lake City, FL

NPI 1003022351 Organization Prosthetic/Orthotic Supplier Medicare Supplier Does Not Accept Medicare Approved Payment

About MID-FLORIDA PROSTHETICS & ORTHOTICS (M & M REHAB INC)

Mid-florida Prosthetics & Orthotics (m & M Rehab Inc) is a provider established in Lake City, Florida specializing in prosthetic/orthotic supplier. The NPI number of Mid-florida Prosthetics & Orthotics (m & M Rehab Inc) is 1003022351 and was assigned on May 2007. The practitioner's primary taxonomy code is 335E00000X. The provider is registered as an organization and their NPI record was last updated one year ago. The provider's is doing business as Mid-florida Prosthetics & Orthotics. The authorized official of this NPI record is Mr. Victor Bustamante Cpo (President)

Mid-florida Prosthetics & Orthotics is a medicare supplier with PTAN 1267440003 who does not accept Medicare assignment for all durable medical equipment and supplies. The provider may not accept the Medicare allowable as payment in full and may collect additional payment directly from the patient, and/or charge more than the Medicare allowable.The supplier carries the following product categories: Orthoses: Off-The-Shelf or Diabetic Shoes and Inserts or Diabetic Shoes/Inserts - Custom or Orthoses: Custom Fabricated or Orthoses: Prefabricated (Non-Custom Fabricated) or Limb Prostheses.

NPI

1003022351

Provider NameMID-FLORIDA PROSTHETICS & ORTHOTICS (M & M REHAB INC)
Provider Location Address221 SW STONEGATE TER STE 107 LAKE CITY, FL 32024
Provider Mailing Address6608 NW 9TH BLVD GAINESVILLE, FL 32605
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameMID-FLORIDA PROSTHETICS & ORTHOTICS
Other Name TypeDoing Business As (3)
Enumeration Date05-15-2007
Last Update Date08-07-2020


Primary Taxonomy

Taxonomy Code335E00000X
ClassificationProsthetic/Orthotic Supplier
TypeSuppliers
Taxonomy DescriptionAn organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.

Business Address

MID-FLORIDA PROSTHETICS & ORTHOTICS
221 SW STONEGATE TER STE 107
LAKE CITY, FL
ZIP 32024
Phone: (386) 755-5774
Fax: (352) 331-9927

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Mailing Address

MID-FLORIDA PROSTHETICS & ORTHOTICS
6608 NW 9TH BLVD
GAINESVILLE, FL
ZIP 32605
Phone: (352) 331-3399
Fax: (352) 331-9927



Authorized Official

Authorized Official NameMR. VICTOR BUSTAMANTE CPO
Authorized Official TitlePRESIDENT
Authorized Official Phone(352) 331-3399

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN1267440003
Accepts Medicare AssignmentNO
Specialities ListProsthetic Personnel, Orthotic Personnel.
Supplies List
  • Orthoses: Off-The-Shelf - Met pads, Heel pads, Heel spur pads
  • Diabetic Shoes and Inserts - Shoes, Socks, Insoles
  • Diabetic Shoes/Inserts - Custom - Custom fabricated shoes, socks, & insoles
  • Orthoses: Custom Fabricated - Custom met pads, Custom heel pads, Custom heel spur pads
  • Orthoses: Prefabricated (Non-Custom Fabricated) - Met pads, Heel pads, Heel spur pads
  • Limb Prostheses - Prosthetic arms, Prosthetic feet, Prosthetic knees
Competitive BiddingNO

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.