Provider Demographics
NPI:1407901705
Name:DBR DEVELOPMENT CORP.
Entity Type:Organization
Organization Name:DBR DEVELOPMENT CORP.
Other - Org Name:FOOT SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED ORTHOTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ROEHL
Authorized Official - Suffix:
Authorized Official - Credentials:CO
Authorized Official - Phone:407-973-9480
Mailing Address - Street 1:145 PALM BAY RD NE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:WEST MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-8601
Mailing Address - Country:US
Mailing Address - Phone:321-725-8750
Mailing Address - Fax:321-725-8755
Practice Address - Street 1:145 PALM BAY RD NE
Practice Address - Street 2:SUITE 108
Practice Address - City:WEST MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-8601
Practice Address - Country:US
Practice Address - Phone:321-725-8750
Practice Address - Fax:321-725-8755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLORT 33332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLM2833OtherBC/BS
FLM2833OtherBC/BS
FLM2833OtherBC/BS