Provider Demographics
NPI:1467027318
Name:PROCARE ORTHOPEDICS, INC
Entity type:Organization
Organization Name:PROCARE ORTHOPEDICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED ORTHOTIST/PROSTHETIST
Authorized Official - Prefix:MR
Authorized Official - First Name:NAJMUS
Authorized Official - Middle Name:S
Authorized Official - Last Name:FARUQUI
Authorized Official - Suffix:
Authorized Official - Credentials:CPO, CPED
Authorized Official - Phone:954-448-1640
Mailing Address - Street 1:10200 W STATE ROAD 84 STE 220
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33324-4220
Mailing Address - Country:US
Mailing Address - Phone:954-448-1640
Mailing Address - Fax:
Practice Address - Street 1:10200 W STATE ROAD 84 STE 220
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33324-4220
Practice Address - Country:US
Practice Address - Phone:954-448-1640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies