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General NPI Number Information
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NPI Number | 1063758266
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Entity Type | Organization
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Legal Business Name | BRANDY'S SHOES USA , INC
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Dates
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Enumeration Date | 12/17/2012
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Last Update Date | 12/17/2012
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Provider Practice Location Address
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Address Line | 1290 N FEDERAL HWY
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City | POMPANO BEACH
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State | FL
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Zip | 33062-3705
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Country | US
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Telephone | 954-943-9667
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Fax |
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Provider Business Mailing Address
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Address Line | 1290 N FEDERAL HWY
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City | POMPANO BEACH
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State | FL
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Zip | 33062-3705
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MOHAMMED ASAM ASAD
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Credential | M.D
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Telephone | 954-943-9667
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | PED159
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License Number State | FL
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