MEDICARE: SOUTH BEACH ORTHOTICS & PROSTHETICS 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	HCC6065	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	:	1881616720
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH BEACH ORTHOTICS & PROSTHETICS INC

Provider Business Mailing Address
First Line	:	4147 SUN N LAKE BLVD
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33872-2131
Country	:	US
Telephone Number	:	305-672-9393
Fax Number	:	305-675-3706

Provider Business Practice Location Address
First Line	:	4735 PALM AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-4037
Country	:	US
Telephone Number	:	305-672-9393
Fax Number	:	305-675-3706

Authorized Official
Title or Position	:	GENERAL MANAGER
Name	:	MR. MARK SELLECK
Credential	:	ORF
Telephone Number	:	561-394-4200

Provider Enumeration Date	:	07/23/2006
Last Update Date	:	07/06/2023

Similar Medicare Providers

1457345647 — V & M MEDICAL SUPPLY INC
Practice Location Address:

4701 PALM AVE , SUITE A
HIALEAH, FL
33012-4037

Practice Phone: 305-819-4568
Practice Fax: 305-819-4538

1205076676 — SOUTH BEACH ORTHOTICS & PROSTHETICS INC
Practice Location Address:

4735 PALM AVE
HIALEAH, FL
33012-4037

Practice Phone: 561-394-4200
Practice Fax: 561-394-4422

1851647499 — DOUBLE NINE SENIORS CLUB INC.
Practice Location Address:

4719 PALM AVE
HIALEAH, FL
33012-4037

Practice Phone: 305-825-4459
Practice Fax: 305-825-4454

1457939217 — YAIRELIN ABREU
Practice Location Address:

4037 W 9TH LN
HIALEAH, FL
33012-7233

Practice Phone: 786-546-8155
Practice Fax:

1053376871 — NOUVEAU P & O LTD
Practice Location Address:

5422 FORT HAMILTON PKWY
BROOKLYN, NY
11219-4037

Practice Phone: 718-871-2222
Practice Fax: 718-871-1478

1316047350 — LIFESHAPES BOUTIQUE INC
Practice Location Address:

518 LAKEWOOD DR
BRANDON, FL
33510-4037

Practice Phone: 813-654-6968
Practice Fax: 813-655-6968

Directions to “SOUTH BEACH ORTHOTICS & PROSTHETICS INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.