MARK GIBSON CPO NPI 1619391802

NPI Information

NPI: 1619391802
Provider Name: MARK GIBSON, CPO
Classification: Prosthetist - 224P00000X
Entity Type: Individual
Address:
3334 CAPITAL MEDICAL BLVD #400
TALLAHASSEE, FL
ZIP 32308
Phone: (850) 877-8174
Get Directions

Mark Gibson, CPO is a prosthetist in Tallahassee, FL. The provider is a health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. Mark Gibson, CPO NPI is 1619391802. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3334 CAPITAL MEDICAL BLVD #400
TALLAHASSEE, FL
ZIP 32308-470
Phone: (850) 877-8174
Fax: (850) 877-5636

The enumeration date for this NPI number is 2/10/2014 and was last updated on 11/13/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	222Z00000X	Orthotist		POR276	FLORIDA	No
2	224P00000X	Prosthetist		POR276	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	951939400	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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