MEDICARE: SELF-CARE BRACING, 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1154819498
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SELF-CARE BRACING, INC

Provider Business Mailing Address
First Line	:	18350 NW 2ND AVE STE 406D
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-4519
Country	:	US
Telephone Number	:	305-705-3571
Fax Number	:	305-705-3574

Provider Business Practice Location Address
First Line	:	18350 NW 2ND AVE STE 406D
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-4519
Country	:	US
Telephone Number	:	305-705-3571
Fax Number	:	305-974-2750

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTINE TRUGLIA
Credential	:
Telephone Number	:	305-705-3571

Provider Enumeration Date	:	04/23/2018
Last Update Date	:	04/04/2019

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