ITALY SHOE LAB INC NPI 1962455873

NPI Information

  • NPI: 1962455873
  • Provider Name: ITALY SHOE LAB, INC
  • Classification: Prosthetic/Orthotic Supplier - 335E00000X
  • Entity Type: Organization
  • Address: 16621 HWY 301 S
    #107
    WIMAUMA, FL
    ZIP 33598
  • Phone: (813) 645-5800

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NPI Details

ITALY SHOE LAB, INC is a prosthetic orthotic supplier in Wimauma, FL. The provider is an organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. ITALY SHOE LAB, INC NPI is 1962455873. The provider is registered as an organization entity type.

The provider's business location address is:

16621 HWY 301 S
#107
WIMAUMA, FL
ZIP 33598
Phone: (813) 645-5800
Fax: (813) 641-0319

The provider's authorized official is Jeffrey M Corniello .
The authorized official title is Vice-president and has the following contact phone number (813) 645-5800.

The enumeration date for this NPI number is 5/19/2006 and was last updated on 2/27/2008.

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
1335E00000XProsthetic/Orthotic SupplierNO PED 76FLORIDAYes

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
14914920001MEDICARE ID-TYPE UNSPECIFIEDFLORIDAWIMAUMA

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: 11/21/2025

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