Healthcare Provider Details

I. General information

NPI: 1134202591
Provider Name (Legal Business Name): FENTON BRACE & LIMB CO., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8740 N KENDALL DR SUITE 112
MIAMI FL
33176-2212
US

IV. Provider business mailing address

8740 N KENDALL DR SUITE 112
MIAMI FL
33176-2212
US

V. Phone/Fax

Practice location:
  • Phone: 305-274-7557
  • Fax: 305-274-1316
Mailing address:
  • Phone: 305-274-7557
  • Fax: 305-274-1316

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: MR. R. JAMES FENTON
Title or Position: PRESIDENT
Credential: CPO, LPO
Phone: 305-274-7557