SOUTH BEACH ORTHOTICS AND PROSTHETICS (NPI# 1467812099) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467812099 |
| Entity Type | Organization |
| Organization Name | SOUTH BEACH ORTHOTICS AND PROSTHETICS |
| Practice Address |
1130 1st St S Winter Haven FL 33880-3903 |
| Mailing Address |
3350 Nw 2nd Ave Ste B18 Boca Raton FL 33431-6678 |
| Practice Telephone | 8638753355 |
| Mailing Telephone | 3052005940 |
| Enumeration Date | 2016-02-24 |
| Last Update Date | 2016-02-24 |
| Authorized Official Name | MR. MARK SELLECK (PRESIDENT/OWNER) |
| Authorized Official Telephone | 5617222428 |
| Authorized Official Credential | POR |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | POR175 | FL | Suppliers |
| Street Address |
1130 1ST ST S |
| City | WINTER HAVEN |
| State | FL |
| Zip Code | 33880-3903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528427150 | Winter Haven Family Practice, Pa | Clinic/Center | 1130 1st St S, Winter Haven, FL 33880-3903 | 2016-02-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851896955 | Cheryl Gonzalez | Physical Therapy Assistant | 1601 6th Street Swe, Winter Haven, FL 33880 | 2018-03-29 |
| 1265950661 | Integrity Prosthetics and Orthotics | Prosthetic/Orthotic Supplier | 135 1st Street South, Winter Haven, FL 33880 | 2017-09-06 |
| 1912423427 | Stacy Lewis | Counselor | 1943 Ave E Sw, Winter Haven, FL 33880 | 2017-08-16 |
| 1497275952 | Kleine Pediatrics | Pediatrics | 375 E Central Avenue, Suite 391, Winter Haven, FL 33880 | 2017-06-26 |
| 1255851457 | Farah N Habib | Dentist | 375 E Central Ave, Suite 361, Winter Haven, FL 33880 | 2017-06-20 |
| 1356878086 | Congruent Hearts Companions | Home Health | 111 Ave R N.e., Winter, FL 33880 | 2017-05-12 |
| 1689033201 | Jason Acosta | General Practice | 111 Avenue A Se, Winter Haven, FL 33880 | 2016-02-11 |
| 1629440573 | National Vision, Inc. | Technician/Technologist | 341 & 343 Cypress Gardens Blvd, Winter Haven, FL 33880 | 2015-10-30 |
| 1518336825 | Nicole A. Domenech | General Practice | 950 First St. South, Winter Haven, FL 33880 | 2015-09-16 |
| 1447666417 | Lee Tramell Vickers | Pharmacist | 701 1st Street, Winter Haven, FL 33880 | 2014-07-10 |
| Find all providers in zip 33880 | ||||
| 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 |
|---|---|---|---|---|
| 1265950661 | Integrity Prosthetics and Orthotics | Prosthetic/Orthotic Supplier | 135 1st Street South, Winter Haven, FL 33880 | 2017-09-06 |
| 1306082722 | Newbold Prosthetics, LLC | Prosthetic/Orthotic Supplier | 1547 7th St Sw, Winter Haven, FL 33880-3802 | 2009-01-07 |
| 1750362471 | Faatz, Inc | Prosthetic/Orthotic Supplier | 210 E Central Ave, Winter Haven, FL 33880-6311 | 2005-11-09 |
| 1508041112 | Medcare Services of Orlando, Inc. | Prosthetic/Orthotic Supplier | 1547 7th St Sw, Winter Haven, FL 33880-3802 | 2008-01-02 |
| 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 | ||||
| City | WINTER HAVEN |
| Zip Code | 33880 |
Please comment or provide details below to improve the information on SOUTH BEACH ORTHOTICS AND PROSTHETICS.
| 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.