Provider Demographics
NPI:1568521581
Name:FENTON BRACE & LIMB CO., INC.
Entity Type:Organization
Organization Name:FENTON BRACE & LIMB CO., INC.
Other - Org Name:FENTON ORTHOTICS & PROSTHETICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:FENTON
Authorized Official - Suffix:
Authorized Official - Credentials:LPO
Authorized Official - Phone:305-274-7557
Mailing Address - Street 1:8740 N KENDALL DR
Mailing Address - Street 2:SUITE 112
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2212
Mailing Address - Country:US
Mailing Address - Phone:305-274-7557
Mailing Address - Fax:305-274-1316
Practice Address - Street 1:4151 N ANDREWS AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-4745
Practice Address - Country:US
Practice Address - Phone:954-584-5434
Practice Address - Fax:954-967-0800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1023171OtherUHC
FLM0049OtherBCBS