SOUTH BEACH ORTHOTICS & PROSTHETICS, INC (NPI# 1497007447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497007447 |
| Entity Type | Organization |
| Organization Name | SOUTH BEACH ORTHOTICS & PROSTHETICS, INC |
| Practice Address |
1275 W Granada Blvd Suite A6 Ormond Beach FL 32174-8259 |
| Mailing Address |
3350 Nw 2nd Avenue Suite B-18 Boca Raton FL 33431 |
| Practice Telephone | 3862369912 |
| Practice Fax Number | 3863108657 |
| Mailing Telephone | 5613944200 |
| Mailing Fax Number | 5613944422 |
| Enumeration Date | 2012-10-15 |
| Last Update Date | 2014-03-25 |
| 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 |
| 1477999837 | South Beach Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 6817 Southpoint Parkway, Suite 2303, Jacksonville, FL 32216 | 2013-05-13 |
| 1912259961 | South Beach Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 2325 Ulmerton Rd, Suite 23, Clearwater, FL 33762-2282 | 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 |
1275 W GRANADA BLVD SUITE A6 |
| City | ORMOND BEACH |
| State | FL |
| Zip Code | 32174-8259 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831199710 | Coastal Pediatrics LLC | Clinic/Center | 1275 W Granada Blvd, Ste 3a, Ormond Beach, FL 32174-8259 | 2005-07-21 |
| 1699202127 | Mohammad Uzair Bawany | Dentist | 1275 W Granada Blvd, Ormond Beach, FL 32174-8259 | 2017-05-15 |
| 1902252117 | Laura Hutson | Physical Therapy Assistant | 1275 W Granada Blvd, Suite 4 B 2, Ormond Beach, FL 32174-8259 | 2016-05-05 |
| 1740682293 | Niccatti Honaker | Physical Therapist | 1275 W Granada Blvd, Suite 4b2, Ormond Beach, FL 32174-8259 | 2014-09-16 |
| 1457789695 | Shc Home Health Services - Jacksonville, LLC | Home Health | 1275 W Granada Blvd, Suite 6b, Ormond Beach, FL 32174-8259 | 2013-10-25 |
| 1083966857 | Matthew James Sheltz | Physical Therapist | 1275 W Granada Blvd, Suite 4b2, Ormond Beach, FL 32174-8259 | 2012-10-04 |
| 1912286386 | Coastal Health Services, Inc | Home Health | 1275 W Granada Blvd, Ste 6b, Ormond Beach, FL 32174-8259 | 2011-08-16 |
| 1104018233 | Paul K Gulliksen | Physical Therapist | 1275 W Granada Blvd, Suite 6b, Ormond Beach, FL 32174-8259 | 2007-08-13 |
| 1780888321 | Coastal Pediatrics | Pediatrics | 1275 W Granada Blvd, Suite 3a, Ormond Beach, FL 32174-8259 | 2007-06-14 |
| 1982815650 | Orthopedic Surgery and Sports Med | Orthopaedic Surgery | 1275 W Granada Blvd, Suite 3b, Ormond Beach, FL 32174-8259 | 2007-05-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215574991 | Case Vision Pa | Optometrist | Eye Savers, 1474 W. Granada Blvd. #470, Ormond Beach, FL 32174 | 2019-12-02 |
| 1235797143 | Galia Leilani Medrano Ramirez | Dentist | 1274 W. Granada Blvd, Ormond Beach, FL 32174 | 2019-06-05 |
| 1295299220 | Jessica Johnson Hills | Nurse Practitioner | 1400 Hand Ave Ste K, Ormond Beach, FL 32174 | 2019-01-23 |
| 1437507043 | Natasha Jairam | Family Medicine | Adventhealth Medical Group Family Medicine, 400 Clyde Morris Blvd Ste A, Ormond Beach, FL 32174 | 2016-05-25 |
| 1871956540 | Lisa Anne Parissi | Chiropractor | 157 Kimberly Drive, Ormond Beach, FL 32174 | 2016-03-31 |
| 1023477940 | Ambassador Health Services, Inc | In Home Supportive Care | 136 N Orchard St Ste 1, Ormond Beach, FL 32174 | 2016-02-19 |
| 1619341518 | Maria Rogers | Optometrist | 9 Abacus Ave, Ormond Beach, FL 32174 | 2015-11-16 |
| 1285003830 | Sydney Kalin Neuhardt | Nurse Practitioner | 725 W. Granada Blvd. Ste 1, Ormond Beach, FL 32174 | 2015-09-24 |
| 1194107821 | Jerusha Thacker | Case Manager/Care Coordinator | 259 Bill France Blvd. Ste 200, Daytona Beach, FL 32174 | 2015-06-18 |
| 1730569971 | Daniel Joseph Lapolla | Physical Therapy Assistant | 1275 Granada Blvd, Suite 4b2, Ormond Beach, FL 32174 | 2015-06-03 |
| Find all providers in zip 32174 | ||||
| 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 |
|---|---|---|---|---|
| 1073924866 | B&g Rehab Inc. | Prosthetic/Orthotic Supplier | 533 N Nova Rd, Suite 109, Ormond Beach, FL 32174-4447 | 2014-05-14 |
| 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 | ORMOND BEACH |
| Zip Code | 32174 |
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.