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General NPI Number Information
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NPI Number | 1538118518
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Entity Type | Organization
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Legal Business Name | TABRAUE ORTHOPEDIC MEDICAL SUPPLY
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Dates
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Enumeration Date | 05/08/2006
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Last Update Date | 04/12/2016
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Provider Practice Location Address
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Address Line | 106 SW 16TH AVE
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City | MIAMI
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State | FL
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Zip | 33135-2116
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Country | US
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Telephone | 305-649-4460
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Fax | 305-649-9249
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Provider Business Mailing Address
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Address Line | 106 SW 16TH AVE
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City | MIAMI
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State | FL
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Zip | 33135-2116
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Country | US
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Telephone | 305-649-4460
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Fax | 305-649-9249
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAUL TABRAUE
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Credential |
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Telephone | 305-649-4460
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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 | ORF189
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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