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Contact Information

THE SHOE LAB, INC
1201 1ST ST SW
RUSKIN, FL33570
 Phone: 813-645-5800
 Fax: 813-641-0319
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Prosthetic/Orthotic Supplier

335E00000X 51 Medical Supply Company with Orthotist
Indicates primary specialty

NPI Profile & details for THE SHOE LAB, INC

NPI # 1730365453
LBN Legal business name THE SHOE LAB, INC
Authorized official JEFFREY CORNIELLO - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 01/11/2008
Last updated 08/31/2018 - About 8 years ago
Identifiers
FL License # PED 76
FL Medicaid 001855300
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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