MEDICARE: FLORIDA BRACING CENTERS 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	224P00000X	Prosthetist	POR141	FL
2	332B00000X	Durable Medical Equipment & Medical Supplies	1312313	FL
3	222Z00000X	Orthotist	ORT109	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	:	1356337604
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA BRACING CENTERS INC

Provider Business Mailing Address
First Line	:	500 SE 17TH ST
Second Line	:	SUITE 301
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-2547
Country	:	US
Telephone Number	:	954-525-6700
Fax Number	:	954-525-4330

Provider Business Practice Location Address
First Line	:	500 SE 17TH ST
Second Line	:	SUITE 301
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-2547
Country	:	US
Telephone Number	:	954-525-6700
Fax Number	:	954-525-4330

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JAMES MATTERN
Credential	:
Telephone Number	:	954-525-6700

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	04/14/2009

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Directions to “FLORIDA BRACING CENTERS INC ” Practice Location

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