MEDICARE: BROTHERS & DREAMS CORPORATION

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	332B00000X	Durable Medical Equipment & Medical Supplies	332B00000X	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
2	1313469	OTHER	FL	AHCA

General Provider Information

NPI Number	:	1124209150
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROTHERS & DREAMS CORPORATION

Provider Business Mailing Address
First Line	:	7592 S US HIGHWAY 1
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34952-1450
Country	:	US
Telephone Number	:	772-878-2057
Fax Number	:	772-878-2058

Provider Business Practice Location Address
First Line	:	7592 S US HIGHWAY 1
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34952-1450
Country	:	US
Telephone Number	:	772-878-2057
Fax Number	:	772-878-2058

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. OSWALDO HERRERA
Credential	:
Telephone Number	:	772-878-2057

Provider Enumeration Date	:	11/19/2007
Last Update Date	:	09/02/2009

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Directions to “BROTHERS & DREAMS CORPORATION ” Practice Location

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