| Organization Name: | GULF COAST ORTHOTICS & PROSTHETICS CENTER, LLC |
| NPI Number: | 1588087001 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LILLIANE M RODERIQUES (OWNER) |
| Mailing Address: | 21300 Gertrude Ave Port Charlotte |
| State: | FL US |
| Postal Code: | 339525002 |
| Phone Number: | 9414086246 |
| Fax Number: | 9412498956 |
| NPI Enumeration Date: | 02/04/2014 |
| NPI Last Update Date: | 03/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | POR181 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |