Provider Demographics
NPI:1780689646
Name:HUSE ARTIFICIAL LIMB & BRACE, INC.
Entity Type:Organization
Organization Name:HUSE ARTIFICIAL LIMB & BRACE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:S
Authorized Official - Last Name:HUSE
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:954-432-0355
Mailing Address - Street 1:9668 PINES BLVD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6245
Mailing Address - Country:US
Mailing Address - Phone:954-432-0355
Mailing Address - Fax:954-432-2062
Practice Address - Street 1:9668 PINES BLVD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6245
Practice Address - Country:US
Practice Address - Phone:954-432-0355
Practice Address - Fax:954-432-2062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-16
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPOR 79335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
40961OtherNHP PROVIDER NUMBER
101887OtherAVMED
M2242OtherBCBS
M2242OtherBCBS
=========OtherFEDERAL ID NUMBER