Healthcare Provider Details

I. General information

NPI: 1497930887
Provider Name (Legal Business Name): TROPICAL BRACE AND LIMB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2008
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 W OAK ST
KISSIMMEE FL
34741-4416
US

IV. Provider business mailing address

1009 MAITLAND CENTER COMMONS BLVD STE 205
MAITLAND FL
32751-7270
US

V. Phone/Fax

Practice location:
  • Phone: 407-897-2104
  • Fax: 407-897-2133
Mailing address:
  • Phone: 407-897-2112
  • Fax: 407-897-2133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberPOR43
License Number StateFL

VIII. Authorized Official

Name: MICHAEL NEWMYER
Title or Position: COO
Credential:
Phone: 844-759-5462