Organization
GULF COAST LIMB & BRACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALBERTO L ALVAREZ ORTHOTIST/PROSTHETIS (OWNER)
(228) 864-4512
Entity
Organization
Contact information
Practice address
3506 WASHINGTON AVE STE D, GULFPORT, MS 39507-3102
(228) 864-4512
(228) 864-5339
Mailing address
3506 WASHINGTON AVE, SUITE D, GULFPORT, MS 39507-3103
(228) 864-4512
(228) 864-5339
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00011709
BLUE CROSS
MS
05
—
00040133
—
MS
Enumeration date
07/24/2006
Last updated
05/05/2022
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