Brevard Prosthetics & Orthotics, Inc
Organization Active NPI Prosthetic/Orthotic Supplier · Estero, FL
NPI 1144692013 · NPPES record last updated Sep 2, 2025
Key facts
- NPI
- 1144692013
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Prosthetic/Orthotic Supplier 335E00000X
- Legal business name
- BREVARD PROSTHETICS & ORTHOTICS, INC
- Practice address
- 10201 Arcos Ave Ste 104
Estero, FL 33928-9460 - Phone
- (239) 955-4778
- Fax
- (321) 638-4559
- NPI assigned
- Oct 30, 2015
- Organization subpart
- Yes
- Parent organization (as reported)
- BREVARD PROSTHETICS & ORTHOTICS, INC.
Authorized official
- Name
- Laura Allen
- Title
- Contracting Manager
- Phone
- (336) 339-9671
Parent organization (reported in NPPES) 1
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 3
Member of 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160329002053 | FL | DME Supplier - Medical Supply Company With Orthotic-Prosthetic | 1557482445 | Practice locations: Fort Myers, FL |
National Provider Directory
- Tax ID family
- Brevard Prosthetics Orthotics Inc
- Part of
- Brevard Prosthetics Orthotics Inc
Locations
10201 Arcos Ave
Ste 104
Estero, FL 33928
Phone (239) 955-4778
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | FL | Yes |
Addresses
Primary practice location
10201 Arcos Ave Ste 104
Estero, FL 33928-9460
Mailing address
8695 Connecticut St Ste E
Merrillville, IN 46410-6240
Phone (321) 225-8001
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 016079800 | Medicaid | FL |
Other names
- Cardinal P & O
Other providers in Estero, FL
- Boyrer Chiropractic P a
- Michael G Boyrer
- Thomas C Brady
- Kaia Bravo
- Breakthrough Counseling Services, LLC
- Bruce Michael Bridewell
- Stephen Danyael Bridges
- Rochelle Lynn Brindley
- Giselle Brito Mantilla
- Lindsay S Brown
All providers in Estero, FL · Prosthetic/Orthotic Supplier in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.