Organization Active NPI

Tampa Bay Orthopaedic Designs Inc

  • Prosthetic/Orthotic Supplier
  • Brandon, FL
National Provider Identifier
1629061007
Registry record updated Oct 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
POR124 Issued in FL
Legal business name
TAMPA BAY ORTHOPAEDIC DESIGNS INC
Practice address
667 S Kings Ave
Brandon, FL 33511-6048
Phone
(813) 224-0525
Fax
(813) 315-9062
NPI assigned
Aug 31, 2005
Last updated
Oct 29, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Olaf Mickle Holm Sr., LPO, CO, BOCPONPI 1740797901
Title
Owner/President
Phone
(813) 224-0525

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X POR124 FL Primary

Addresses

Primary practice location

667 S Kings Ave
Brandon, FL 33511-6048

Mailing address

1463 Oakfield Dr Ste 134
Brandon, FL 33511-0801
Phone (813) 224-0525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930040195 FL DME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 7012037146 Practice locations: Tampa, FL

National Provider Directory

National Provider Directory

Locations

1463 Oakfield Dr
Ste 134
Brandon, FL 33511
Phone (813) 489-4547

812 W Dr Martin Luther King Jr Blvd
Ste 100
Tampa, FL 33603
Phone (813) 224-0525

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1793232000000",
    "number": "1629061007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1463 OAKFIELD DR STE 134",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335110801",
            "telephone_number": "813-224-0525",
            "fax_number": "813-315-9062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 S KINGS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116048",
            "telephone_number": "813-224-0525",
            "fax_number": "813-315-9062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMPA BAY ORTHOPAEDIC DESIGNS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-31",
        "last_updated": "2026-10-29",
        "certification_date": "2026-10-29",
        "status": "A",
        "authorized_official_last_name": "HOLM",
        "authorized_official_first_name": "OLAF",
        "authorized_official_middle_name": "MICKLE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "813-224-0525",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "LPO, CO, BOCPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "FL",
            "license": "POR124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.