OrganizationActive
Sun State Prosthetics Inc
NPI 1194843797 · Prosthetist · Daytona Beach, FL
Provider details
- NPI number
- 1194843797
- Entity type
- Organization
- Primary specialty
- ProsthetistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Parent organization
- Sun State Prosthetics Inc
- Organization subpart
- Yes
- Authorized official
- Charles Gano, Owner(407) 629-2866
- License
- PRO 12 (FL)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
756 Berkshire Rd
Daytona Beach, FL 32114-1602
Phone: (407) 629-2866
Fax: (407) 629-4277
Street-level locationGet directions
Mailing address
1444 W Fairbanks Ave
Winter Park, FL 32789-4806
Registry dates
- Enumerated
- 2007-03-26
- Last updated
- 2016-09-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.