South Broward Brace & Surgical Supports Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

ORT38 Issued in FL

Legal business name

SOUTH BROWARD BRACE & SURGICAL SUPPORTS INC

Practice address

1920 E Hallandale Beach Blvd
Ste 702
Hallandale Beach, FL 33009-4722

Phone

(954) 922-9061

Fax

(954) 458-8611

NPI assigned

Oct 3, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Vincent T Petti, LO

Title

Owner

Phone

(954) 922-9061

Specialties & licenses 1

Addresses

Tax ID family

South Browaid Brace Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• South Browaid Brace Inc

  • Prosthetic/Orthotic Supplier
  • Hollywood, FL
  • NPI 1881772853
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255328431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 E HALLANDALE BEACH BLVD",
            "address_2": "STE 702",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094722",
            "telephone_number": "954-922-9061",
            "fax_number": "954-458-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 E HALLANDALE BEACH BLVD",
            "address_2": "STE 702",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094722",
            "telephone_number": "954-922-9061",
            "fax_number": "954-458-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BROWARD BRACE & SURGICAL SUPPORTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETTI",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-922-9061",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "FL",
            "license": "ORT38",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gordon George Souaid, M.D.
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• South Florida Neurology Center PA
• South Florida Pain Clinic, LLC

• Prosthetic/Orthotic Supplier in Hallandale Beach, FL
• Providers in Hallandale Beach, FL by specialty
• Prosthetic/Orthotic Supplier in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.