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General NPI Number Information
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NPI Number | 1831379817
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Entity Type | Organization
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Legal Business Name | BERRY ORTHOPEDIC INC
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Dates
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Enumeration Date | 11/07/2007
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Last Update Date | 08/29/2018
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Provider Practice Location Address
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Address Line | 1875 NE 163RD ST
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162
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Country | US
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Telephone | 305-651-3040
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Fax | 305-651-3237
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Provider Business Mailing Address
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Address Line | PO BOX 540596
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City | OPA LOCKA
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State | FL
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Zip | 33054-0596
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Country | US
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Telephone | 305-651-3040
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Fax | 305-651-3237
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Authorized Official
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Title or Position | PRESIDENT/ OWNER
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Name | MR. RAYMOND BERRY
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Credential | L.P.O. C.P.O.
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Telephone | 305-651-3040
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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 | POR 107
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | POR 107
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License Number State | FL
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