Provider Demographics
NPI:1710420740
Name:VMH BRACING LLC
Entity Type:Organization
Organization Name:VMH BRACING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-515-5066
Mailing Address - Street 1:5421 BEAUMONT CENTER BLVD
Mailing Address - Street 2:SUITE 630
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-5200
Mailing Address - Country:US
Mailing Address - Phone:813-515-5066
Mailing Address - Fax:
Practice Address - Street 1:5421 BEAUMONT CENTER BLVD
Practice Address - Street 2:SUITE 630
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-5200
Practice Address - Country:US
Practice Address - Phone:813-515-5066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-22
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL335E00000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier