Provider Demographics
NPI:1437302205
Name:BRANDSMART USA OF SOUTH DADE
Entity Type:Organization
Organization Name:BRANDSMART USA OF SOUTH DADE
Other - Org Name:BRANDSMART USA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-797-4039
Mailing Address - Street 1:3200 SW 42ND ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-6813
Mailing Address - Country:US
Mailing Address - Phone:954-797-4000
Mailing Address - Fax:
Practice Address - Street 1:3200 SW 42ND ST
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-6813
Practice Address - Country:US
Practice Address - Phone:954-797-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies