Active NPI
M & M Rehab., Inc.
Doing business as Mid-Florida Prosthetics & Orthotics
- Prosthetic/Orthotic Supplier
- Leesburg, FL
National Provider Identifier
1871747386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- Legal business name
- M & M REHAB., INC.
- Doing business as
- Mid-Florida Prosthetics & Orthotics
- Practice address
- 601 E Dixie Ave Ste 806
Leesburg, FL 34748-5994 - Phone
- (352) 435-4500
- Fax
- (352) 435-4561
- NPI assigned
- Nov 11, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Victor Bustamante, CPO
- Title
- President
- Phone
- (352) 331-3399
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | Primary |
Addresses
Primary practice location
601 E Dixie Ave Ste 806
Leesburg, FL 34748-5994
Mailing address
2300 SE 17TH St Ste 401
Ocala, FL 34471-9140
Phone (352) 352-3207
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001641300 | Medicaid | FL |
Other names 1
- Mid-Florida Prosthetics & Orthotics
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930084020 | FL | DME Supplier - Prosthetic Personnel | 5698896058 | Practice locations: Leesburg, FL |
Other NPIs with the same Medicare PAC ID 5
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Mid-Florida Prosthetics & Orthotics
- Prosthetic/Orthotic Supplier
- Lake City, FL
- NPI 1003022351
5698896058
-
dba Mid Florida Prosthetics & Orthotics
- Prosthetic/Orthotic Supplier
- Tallahassee, FL
- NPI 1326737636
5698896058
-
dba Mid-Florida Prosthetics & Orthotics
- Prosthetic/Orthotic Supplier
- Gainesville, FL
- NPI 1578565842
5698896058
-
dba Mid-Florida Prosthetics & Orthotics
- Prosthetic/Orthotic Supplier
- Ocala, FL
- NPI 1700017514
5698896058
-
dba Mid-Florida Prosthetics & Orthotics
- Prosthetic/Orthotic Supplier
- Lady Lake, FL
- NPI 1144640186
5698896058
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Mid-Florida Prosthetics & Orthotics | Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items | Does not accept assignment |
National Provider Directory
National Provider Directory- Tax ID family
- M and M Rehab Dba Ortho
Other organizations with this tax ID 6
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Mid-Florida Prosthetics & Orthotics
- Prosthetic/Orthotic Supplier
- Lake City, FL
- NPI 1003022351
-
dba Mid Florida Prosthetics & Orthotics
- Prosthetic/Orthotic Supplier
- Tallahassee, FL
- NPI 1326737636
-
dba Mid-Florida Prosthetics & Orthotics
- Prosthetic/Orthotic Supplier
- Gainesville, FL
- NPI 1578565842
-
dba Mid-Florida Prosthetics & Orthotics
- Prosthetic/Orthotic Supplier
- Ocala, FL
- NPI 1700017514
-
- Prosthetic/Orthotic Supplier
- Jacksonville, FL
- NPI 1730044942
-
dba Mid-Florida Prosthetics & Orthotics
- Prosthetic/Orthotic Supplier
- Lady Lake, FL
- NPI 1144640186
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226361600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1596758400000",
"number": "1871747386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2300 SE 17TH ST STE 401",
"city": "OCALA",
"state": "FL",
"postal_code": "344719140",
"telephone_number": "352-352-3207",
"fax_number": "352-351-3267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 E DIXIE AVE STE 806",
"city": "LEESBURG",
"state": "FL",
"postal_code": "347485994",
"telephone_number": "352-435-4500",
"fax_number": "352-435-4561"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "M & M REHAB., INC.",
"organizational_subpart": "NO",
"enumeration_date": "2008-11-11",
"last_updated": "2020-08-07",
"certification_date": "2020-08-07",
"status": "A",
"authorized_official_last_name": "BUSTAMANTE",
"authorized_official_first_name": "VICTOR",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "352-331-3399",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "CPO"
},
"taxonomies": [
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001641300",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Mid-Florida Prosthetics & Orthotics",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Mid-Florida Prosthetics & Orthotics",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Leesburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.