Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | ORF270 | FL |
NPI | 1841824869 |
---|---|
Provider Name | Mr. Hector L Beza |
First Address | Tampa, FL 33610-3433 |
Second Address | Tampa, FL 33603-3338 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2020 |
Last Update Date | 28/02/2020 |