1427144914 NPI number — CATCH A FALLING ARCH, INC

Table of content: (NPI 1427144914)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427144914 NPI number — CATCH A FALLING ARCH, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CATCH A FALLING ARCH, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FOOT SOLUTIONS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427144914
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/03/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10500 ULMERTON RD
Provider Second Line Business Mailing Address:
SUITE 240
Provider Business Mailing Address City Name:
LARGO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33771-3549
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-585-4200
Provider Business Mailing Address Fax Number:
727-585-4700

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10500 ULMERTON RD
Provider Second Line Business Practice Location Address:
SUITE 240
Provider Business Practice Location Address City Name:
LARGO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33771-3549
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-585-4200
Provider Business Practice Location Address Fax Number:
727-585-4700
Provider Enumeration Date:
10/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FERNANDEZ
Authorized Official First Name:
LAURETTA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
727-585-4200

Provider Taxonomy Codes

  • Taxonomy code: 225000000X , with the licence number:  PED83 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335E00000X , with the licence number: PED83 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: M2736 . This is a "BLUE CROSS BLUE SHIELD FL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: CATCH A . This is a "AARP" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 0007517452 . This is a "AETNA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com