SOUTH BEACH ORTHOTICS & PROSTHETICS, INC (NPI# 1477999837) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477999837 |
| Entity Type | Organization |
| Organization Name | SOUTH BEACH ORTHOTICS & PROSTHETICS, INC |
| Practice Address |
6817 Southpoint Parkway Suite 2303 Jacksonville FL 32216 |
| Mailing Address |
3350 Nw 2nd Avenue Suite B-18 Boca Raton FL 33431 |
| Practice Telephone | 9045516641 |
| Practice Fax Number | 9046838838 |
| Mailing Telephone | 5613944200 |
| Mailing Fax Number | 5613944422 |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2014-03-21 |
| Authorized Official Name | MR. MARK SELLECK (OWNER / PRESIDENT) |
| Authorized Official Telephone | 5613944200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578909966 | South Beach Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 3915 Se Lake Weir Avenue, Ocala, FL 34480 | 2013-05-13 |
| 1659623668 | South Beach Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 1865 N Crystal Lake Dr, Lakeland, FL 33801-5955 | 2012-10-15 |
| 1982985883 | South Beach Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 6545 Nova Dr Ste 203, Davie, FL 33317-7410 | 2011-09-06 |
| 1841590734 | South Beach Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 4147 Sun N Lake Blvd, Sebring, FL 33872-2131 | 2010-10-26 |
| 1346559507 | South Beach Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 7305 Sw Gaines Ave, Stuart, FL 34997-7332 | 2010-10-05 |
| 1912259961 | South Beach Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 2325 Ulmerton Rd, Suite 23, Clearwater, FL 33762-2282 | 2012-10-15 |
| 1497007447 | South Beach Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 1275 W Granada Blvd, Suite A6, Ormond Beach, FL 32174-8259 | 2012-10-15 |
| 1326302928 | South Beach Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 4751 W 4th Ave, Hialeah, FL 33012-3938 | 2012-06-28 |
| Street Address |
6817 SOUTHPOINT PARKWAY SUITE 2303 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700060555 | Iman Naseri | Otolaryngology | 6817 Southpoint Parkway, Suite 502, Jacksonville, FL 32216-6289 | 2007-12-27 |
| 1215368444 | Jana Lorimer | Behavioral Analyst | 6817 Southpoint Parkway, Suite 1501, Jacksonville, FL 32216 | 2013-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524925 | Renee Cherie Titus | Behavior Technician | Growing Together Center 6789 Southpoint Parkway, Building 100, Jacksonville, FL 32216 | 2020-09-24 |
| 1811546575 | First Coast Orthopedic Center, LLC | Clinic/Center | 4035 Southpoint Boulevard, Jacksonville, FL 32216 | 2019-09-05 |
| 1922578558 | Fatima Hussain Crofton | Optometrist | 7051 Southpoint Parkway S 300, Jacksonville, FL 32216 | 2018-11-27 |
| 1154802833 | John-paul Pham | Internal Medicine | 4141 Southpoint Drive East, Suite D, Jacksonville, FL 32216 | 2018-08-22 |
| 1790279479 | Joseph Richard Kennedy | Physician Assistant | 6650 Corporate Center Pkwy Apt 1604, Jacksonville, FL 32216 | 2018-06-18 |
| 1801304357 | Kelli M. Tyson | Nurse Practitioner | 3550 University Blvd. S., Ste 302, Jacksonville, FL 32216 | 2018-01-18 |
| 1376054809 | Angela M Whittinghill | Counselor | 8833 Perimeter Park Blvd #702, Jacksonville, FL 32216 | 2017-10-24 |
| 1629508072 | Zoryana Yufan | Dentist | 8750 Perimeter Park Blvd Ste 101, Jacksonville, FL 32216 | 2017-06-19 |
| 1700318896 | Christina Kaczmarek | Behavior Technician | 6816 Southpoint Pkwy Ste 500, Jacksonville, FL 32216 | 2017-03-29 |
| 1932640422 | Loudine Racius | Nurse Practitioner | 8539 Gate Parkway W, Unit 1422, Jacksonville, FL 32216 | 2017-03-16 |
| Find all providers in zip 32216 | ||||
| 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 |
|---|---|---|---|---|
| 1295367837 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 1300 Riverplace Blvd Ste 100, Jacksonville, FL 32207-1815 | 2020-02-11 |
| 1952955627 | B Jazzy Salon Inc | Prosthetic/Orthotic Supplier | 5116 Gate Pkwy Apt 5111, Jacksonville, FL 32256-0265 | 2019-07-30 |
| 1043771777 | Jimetra West | Prosthetic/Orthotic Supplier | 1449 Morgana Rd, Jacksonville, FL 32211-4910 | 2019-03-26 |
| 1144769092 | Nupath Medical LLC | Prosthetic/Orthotic Supplier | 11244 Turnbridge Dr, Jacksonville, FL 32256-2342 | 2017-02-13 |
| 1700287018 | Janet Johnson | Prosthetic/Orthotic Supplier | 3132 Beach Blvd, Jacksonville, FL 32207-3710 | 2014-09-07 |
| 1043619166 | Nordstrom Inc & Subsidiaries | Prosthetic/Orthotic Supplier | 4835 Town Crossing Drive, Jacksonville, FL 32246-8577 | 2014-08-14 |
| 1053679365 | Jean T. Proulx | Prosthetic/Orthotic Supplier | 3132 Beach Boulevard, Jacksonville, FL 32207-3710 | 2012-04-25 |
| 1023309572 | Bremer Brace of Florida, Inc. | Prosthetic/Orthotic Supplier | 4131 University Blvd S Ste 16, Jacksonville, FL 32216-4346 | 2011-05-02 |
| 1720227465 | Kathleen Elizabeth Brockway | Prosthetic/Orthotic Supplier | 13740 Beach Blvd Ste 404, Jacksonville, FL 32224-6036 | 2009-02-19 |
| 1760637599 | Brandis Wig Salon | Prosthetic/Orthotic Supplier | 7275 103rd St, Jacksonville, FL 32210 | 2008-11-20 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32216 |
Please comment or provide details below to improve the information on SOUTH BEACH ORTHOTICS & PROSTHETICS, INC.
| 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.