South Beach Orthotics & Prosthetics, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

SOUTH BEACH ORTHOTICS & PROSTHETICS, LLC

Practice address

6545 Nova Dr Ste 203
Davie, FL 33317-7410

Phone

(954) 766-4103

Fax

(954) 766-4818

NPI assigned

Sep 6, 2011

Organization subpart

No

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

Authorized official

Name

Ivan Sabel

Title

Ceo

Phone

(863) 658-1291

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• South Beach Orthotics & Prosthetics LLC

  • Prosthetic/Orthotic Supplier
  • Hialeah, FL
  • NPI 1881616720

  7719196112

  Same PAC ID
• South Beach Orthotics & Prosthetics, LLC

  • Prosthetic/Orthotic Supplier
  • Sebring, FL
  • NPI 1841590734

  7719196112

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

South Beach Orthotics Prosthetics Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• South Beach Orthotics & Prosthetics LLC

  • Prosthetic/Orthotic Supplier
  • Hialeah, FL
  • NPI 1881616720
  NPD tax ID
• South Beach Orthotics & Prosthetics, LLC

  • Prosthetic/Orthotic Supplier
  • Sebring, FL
  • NPI 1841590734
  NPD tax ID

Locations

Networks

• HealthSun Health Plans Network

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark T Selleck, LPO,CPO

  • Prosthetic/Orthotic Supplier
  • Sebring, FL
  • NPI 1871519363
  NPD (past)

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

{
    "created_epoch": "1315267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789603200000",
    "number": "1982985883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4147 SUN N LAKE BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722131",
            "telephone_number": "863-658-1291",
            "fax_number": "863-884-1593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6545 NOVA DR STE 203",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333177410",
            "telephone_number": "954-766-4103",
            "fax_number": "954-766-4818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BEACH ORTHOTICS & PROSTHETICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-06",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A",
        "authorized_official_last_name": "SABEL",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "863-658-1291"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005566900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Wiles Sossoman, MPT
• Lakieska Soto
• Natalie Michelle Soto
• Anibal Sotomayor-Santana
• Source Medical Services LLC
• South Broward Pain & Rehabilitation Inc
• South Dental of Davie, Inc
• South Florida Bi-Lingual Speech Therapy, Inc.
• South Florida Cardiology Associates LLC
• South Florida Cardiology Associates LLC

• Prosthetic/Orthotic Supplier in Davie, FL
• Providers in Davie, 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 Sep 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.