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General NPI Number Information
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NPI Number | 1114397783
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Entity Type | Organization
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Legal Business Name | SILENT HILL BRACING & ORTHOPEDIC SUPPLIES, LLC
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Dates
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Enumeration Date | 09/25/2015
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Last Update Date | 09/25/2015
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Provider Practice Location Address
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Address Line | 1108 KANE CONCOURSE SUITE 205-A
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City | BAY HARBOR ISLANDS
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State | FL
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Zip | 33154-2068
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Country | US
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Telephone | 305-866-7751
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Fax | 305-866-7758
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Provider Business Mailing Address
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Address Line | 1108 KANE CONCOURSE SUITE 205-A
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City | BAY HARBOR ISLANDS
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State | FL
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Zip | 33154-2068
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Country | US
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Telephone | 305-866-7751
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Fax | 305-866-7758
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LAWRANCE ALEXANDER
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Credential | MD
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Telephone | 305-866-7751
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State | ZZ
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