Premium Orthotics Corp.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PREMIUM ORTHOTICS CORP.

Practice address

1005 NE 125TH St
North Miami, FL 33161-5810

Phone

(866) 516-5064

NPI assigned

Aug 14, 2015

Organization subpart

No

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

Authorized official

Name

Fernando Nisenbaum

Title

President

Phone

(866) 516-5064

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1439510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476316800000",
    "number": "1689040503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 NE 125TH ST",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331615810",
            "telephone_number": "866-516-5064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 NE 125TH ST",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331615810",
            "telephone_number": "866-516-5064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM ORTHOTICS CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-14",
        "last_updated": "2016-10-13",
        "status": "A",
        "authorized_official_last_name": "NISENBAUM",
        "authorized_official_first_name": "FERNANDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "866-516-5064"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in North Miami, FL
• Providers in North Miami, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; 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.