Healthcare Provider Details

I. General information

NPI: 1295582146
Provider Name (Legal Business Name): WESTCOAST BRACE & LIMB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2024
Last Update Date: 05/22/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3015 ALLEGRA WAY
LUTZ FL
33559
US

IV. Provider business mailing address

5311 E FLETCHER AVE
TEMPLE TERRACE FL
33617-1147
US

V. Phone/Fax

Practice location:
  • Phone: 813-985-5000
  • Fax:
Mailing address:
  • Phone: 813-985-5000
  • Fax: 813-985-4499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SHARON HASSOUN
Title or Position: PRACTICE MANAGER
Credential:
Phone: 813-985-5000