VITAL PROSTHETICS, INC.
NPI 1114189669
Prosthetic/Orthotic Supplier in Marianna, FL

Q: What is Vital Prosthetics, Inc.'s NPI number?

The NPI number for Vital Prosthetics, Inc. is 1114189669. It was assigned to this organization in the NPPES registry on June 26, 2008.

Q: What is Vital Prosthetics, Inc.'s specialty?

The primary specialty registered for this NPI is Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.

Active since June 26, 2008

4299 3RD AVE, MARIANNA, FL 32446(850) 526-0063(850) 526-1317 Get Directions Write a Review

NPPES record last updated: September 18, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Vital Prosthetics, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VITAL PROSTHETICS, INC. (NPI 1114189669) is a healthcare organization registered as a prosthetic/orthotic supplier in Marianna, Florida and active in the NPI registry since June 2008. The organization lists Dale E Petersen, Pres/owner, as its authorized official.

NPPES Registry Identity

NPI1114189669

Entity TypeOrganization

Primary Taxonomy335E00000X

Legal Business NameVITAL PROSTHETICS, INC.

Location Address4299 3RD AVEMarianna, FL 32446-2136

Mailing AddressPo Box 430Marianna, FL 32447-0430 · (850) 526-0063 · Fax (850) 526-1317

Phone(850) 526-0063

Fax(850) 526-1317

Organization SubpartNo

Authorized OfficialDale E PetersenPres/owner · (850) 526-0063

Enumeration DateJune 26, 2008

Last NPPES UpdateSeptember 18, 2008

✔ NPI 1114189669 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyProsthetic/Orthotic SupplierSuppliers

Taxonomy Code335E00000X

License✔ Licensed in FL · PRO 66

Definition

An 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.

4299 3RD AVE, Marianna, FL 32446

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Other Identifiers 1

Medicare NSC6109260001FL

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DALE EDMUND PETERSEN JR. CP

Prosthetist

4299 3RD AVE
MARIANNA, FL 32446

Jackson County (850) 526-0063

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vital Prosthetics, Inc.'s NPI number?

The NPI number for Vital Prosthetics, Inc. is 1114189669. It was assigned to this organization in the NPPES registry on June 26, 2008.

Where is Vital Prosthetics, Inc. located?

Vital Prosthetics, Inc. is located at 4299 3rd Ave, Marianna, FL 32446. The listed phone number is (850) 526-0063.

What is Vital Prosthetics, Inc.'s specialty?

The primary specialty registered for this NPI is Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.

When was this NPI record last updated?

The NPPES record for Vital Prosthetics, Inc. was last updated on September 18, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.