MEDICARE: GARRISON,S PROSTHETIC SERVICE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750387437
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARRISON,S PROSTHETIC SERVICE, INC.

Provider Business Mailing Address
First Line	:	17184 NE 19TH AVE
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-3102
Country	:	US
Telephone Number	:	305-949-1888
Fax Number	:	305-949-5546

Provider Business Practice Location Address
First Line	:	17184 NE 19TH AVE
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-3102
Country	:	US
Telephone Number	:	305-949-1888
Fax Number	:	305-949-5546

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. KEVIN S. GARRISON
Credential	:	C.P., L.P.
Telephone Number	:	305-949-1888

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	08/22/2020

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Directions to “GARRISON,S PROSTHETIC SERVICE, INC. ” Practice Location

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