BREVARD PROSTHETICS & ORTHOTICS, INC. (NPI# 1467597450) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467597450 |
| Entity Type | Organization |
| Organization Name | BREVARD PROSTHETICS & ORTHOTICS, INC. |
| Other Organization Name | BREVARD PROSTHETICS, INC. |
| Practice Address |
1405 Valentine St Melbourne FL 32901-3129 |
| Mailing Address |
2223 S Washington Ave Ste A Titusville FL 32780-4703 |
| Practice Telephone | 3217337778 |
| Practice Fax Number | 3216384559 |
| Mailing Telephone | 3212258001 |
| Mailing Fax Number | 3212253406 |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2020-06-24 |
| Authorized Official Name | MR. ELDON LEROY SWOPES JR. (PRESIDENT) |
| Authorized Official Telephone | 3212258001 |
| Is Organization Subpart | Y |
| Parent Organization Name | BREVARD PROSTHETICS & ORTHOTICS, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 009956400 | 05 |
| Other Name | Type Code |
|---|---|
| Brevard Prosthetics, Inc. | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992840904 | Brevard Prosthetics & Orthotics, Inc. | Prosthetic/Orthotic Supplier | 2223 S Washington Ave Ste A, Titusville, FL 32780-4703 | 2007-02-20 |
| 1073983367 | Brevard Prosthetics & Orthotics, Inc. | Prosthetic/Orthotic Supplier | 21216 Olean Blvd, Suite 1, Port Charlotte, FL 33952-6722 | 2015-09-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BREVARD PROSTHETICS & ORTHOTICS, INC. | 2223 S Washington Ave Ste A, Titusville, FL 32780-4703 |
| Street Address |
1405 VALENTINE ST |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901-3129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
| 1124676820 | Abbi Dell Lee | Behavioral Analyst | 3251 Engineering St, Melbourne, FL 32901 | 2019-08-27 |
| 1750856878 | Jeffrey Michael Cavanagh | Behavior Technician | 3251 Engineering Street, Melbourne, FL 32901 | 2018-10-04 |
| 1740766021 | Amanda Miller | Behavior Technician | 1885 W Hibiscus Blvd, Melbourne, FL 32901 | 2018-07-19 |
| 1396244406 | Dragen II LLC | Urology | 129 W Hibiscus Blvd Ste D, Melbourne, FL 32901 | 2018-02-03 |
| 1225550692 | Cabrit Psychotherapy Services LLC | Marriage & Family Therapist | 100 Rialto Place, Suite 700, Melbourne, FL 32901 | 2017-07-07 |
| 1487188058 | Project Response, Inc. | Clinic/Center | 747 S. Apollo Boulevard, Melbourne, FL 32901 | 2017-04-20 |
| 1184174575 | Paulette Swanson | Physical Therapist | 611 East Sheridan Rd, Melbourne, FL 32901 | 2016-10-10 |
| 1841747839 | Nicholas Wilson | Social Worker | 3661 S. Babcock St., Melbourne, FL 32901 | 2016-09-07 |
| 1467804278 | Nickolas Hetherington | Occupational Therapist | 1900 S Harbor City Blvd Ste 108, Melbourne, FL 32901 | 2016-07-05 |
| Find all providers in zip 32901 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437418860 | South Beach Orthotics & Prosthetics Inc. | Prosthetic/Orthotic Supplier | 2239 S Babcock St, Melbourne, FL 32901-5305 | 2012-05-04 |
| 1942429154 | Ocular Prosthetics Lab Inc | Prosthetic/Orthotic Supplier | 2845 N Harbor City Blvd Ste 2-3, Melbourne, FL 32935-6217 | 2007-04-25 |
| 1982175303 | Premier Orthotics & Prosthetics, LLC | Prosthetic/Orthotic Supplier | 2202 Bryan St, Melbourne, FL 32901-5958 | 2018-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073120192 | Solaris Ortho, LLC | Prosthetic/Orthotic Supplier | 1112 W Shell Point Rd Ste 304, Ruskin, FL 33570-3400 | 2020-09-24 |
| 1467068635 | Laquavian Eliacin | Prosthetic/Orthotic Supplier | 1738 Se Port St Lucie Blvd, Port St Lucie, FL 34952-5467 | 2020-09-22 |
| 1831705805 | Fourroux Prosthetics, Inc | Prosthetic/Orthotic Supplier | 5453 N 59th St, Tampa, FL 33610-2011 | 2020-09-16 |
| 1790397875 | Gessy Rigaud | Prosthetic/Orthotic Supplier | 5100 Sw 41st St Apt 115, Hollywood, FL 33023-6988 | 2020-08-19 |
| 1609486737 | Beauty Vault Lux LLC. | Prosthetic/Orthotic Supplier | 5100 Sw 41st St, Hollywood, FL 33023-6948 | 2020-08-04 |
| 1003424680 | Spartan Capital Investments | Prosthetic/Orthotic Supplier | 1621 E Edgewood Dr Ste B, Lakeland, FL 33803-3365 | 2020-07-20 |
| 1518583012 | Ts&a Medical Supply LLC | Prosthetic/Orthotic Supplier | 13555 Automobile Blvd Ste 650, Clearwater, FL 33762-3854 | 2020-06-19 |
| 1962027128 | Qbc Durable Medical Equipment | Prosthetic/Orthotic Supplier | 931 Village Blvd # 256, West Palm Beach, FL 33409-1803 | 2020-06-13 |
| 1083239891 | K.n. Medical Wigs Inc | Prosthetic/Orthotic Supplier | 651 E Main St Ste I, Haines City, FL 33844-4240 | 2020-06-08 |
| 1730703851 | Mahnke's Orthotics & Prosthetics of Deerfield Inc | Prosthetic/Orthotic Supplier | 4208 N 31st Ave Ste 2, Hollywood, FL 33021-2002 | 2020-06-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.