Provider Demographics
NPI:1962585323
Name:FENTON, R. JAMES (CPO, LPO)
Entity type:Individual
Prefix:MR
First Name:R.
Middle Name:JAMES
Last Name:FENTON
Suffix:
Gender:M
Credentials:CPO, LPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2875 DE SOTO BLVD
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-6312
Mailing Address - Country:US
Mailing Address - Phone:305-461-5122
Mailing Address - Fax:
Practice Address - Street 1:8740 N KENDALL DR
Practice Address - Street 2:SUITE 112
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2212
Practice Address - Country:US
Practice Address - Phone:305-274-7557
Practice Address - Fax:305-274-1316
Is Sole Proprietor?:No
Enumeration Date:2006-10-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPOR 0078222Z00000X, 224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Not Answered224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist