MEDICARE: ALL CUSTOM CORSETS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier	ORF129	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083766547
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL CUSTOM CORSETS INC

Provider Business Mailing Address
First Line	:	2137 SW 8TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135-3319
Country	:	US
Telephone Number	:	305-541-5858
Fax Number	:	305-541-1199

Provider Business Practice Location Address
First Line	:	2137 SW 8TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135-3319
Country	:	US
Telephone Number	:	305-541-5858
Fax Number	:	305-541-1199

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HAYDEE QUIRANTES
Credential	:
Telephone Number	:	305-541-5858

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	12/08/2009

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Directions to “ALL CUSTOM CORSETS INC ” Practice Location

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