Provider Demographics
NPI:1639150600
Name:ORTHORX, INC.
Entity Type:Organization
Organization Name:ORTHORX, INC.
Other - Org Name:FLORIDA SHORES BRACE SYSTEMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-848-0706
Mailing Address - Street 1:2382 FARADAY AVENUE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-7220
Mailing Address - Country:US
Mailing Address - Phone:760-795-5440
Mailing Address - Fax:214-501-0299
Practice Address - Street 1:11760 BIRD RD STE 616
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-8100
Practice Address - Country:US
Practice Address - Phone:305-270-7426
Practice Address - Fax:305-270-7429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004396900Medicaid
FL1313720OtherHME PROVIDER LICENSE
FL004396900Medicaid