Provider Demographics
NPI:1376290502
Name:MED BRACES 1 INC
Entity Type:Organization
Organization Name:MED BRACES 1 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:A
Authorized Official - Last Name:SAAVEDRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-296-1219
Mailing Address - Street 1:6237 PRESIDENTIAL CT STE 140-B
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-3580
Mailing Address - Country:US
Mailing Address - Phone:239-296-1219
Mailing Address - Fax:
Practice Address - Street 1:6237 PRESIDENTIAL CT STE 140-B
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-3580
Practice Address - Country:US
Practice Address - Phone:239-296-1219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies