IndividualActive
Mark Gibson, CPO
NPI 1619391802 · Prosthetist · Tallahassee, FL
Provider details
- NPI number
- 1619391802
- Entity type
- Individual
- Primary specialty
- ProsthetistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- CPO
- Sex
- Male
- Sole proprietor
- No
- License
- POR276 (FL)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
3334 Capital Medical Blvd #400
Tallahassee, FL 32308-4470
Phone: (850) 877-8174
Fax: (850) 877-5636
Approximate (ZIP-level) locationGet directions
Mailing address
3334 Capital Medical Blvd #400
Tallahassee, FL 32308-4470
Registry dates
- Enumerated
- 2014-02-10
- Last updated
- 2014-11-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.