Provider Demographics
NPI:1053667071
Name:FLORIDA BRACING CENTERS, INC.
Entity Type:Organization
Organization Name:FLORIDA BRACING CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-917-5655
Mailing Address - Street 1:500 SE 17TH ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-2547
Mailing Address - Country:US
Mailing Address - Phone:954-917-5655
Mailing Address - Fax:954-971-7773
Practice Address - Street 1:201 SAINT CHARLES AVE
Practice Address - Street 2:SUITE 2542
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70170-1000
Practice Address - Country:US
Practice Address - Phone:504-599-5639
Practice Address - Fax:504-599-5629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-27
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies