Organization
BREVARD PROSTHETICS & ORTHOTICS, INC
Active
Parent organization
BREVARD PROSTHETICS & ORTHOTICS, INC.
Other names
Cardinal P & O
Organization subpart
Yes
Provider details
NPI number
Legal business name
BREVARD PROSTHETICS & ORTHOTICS, INC.
Authorized official
LAURA ALLEN (CONTRACTING MANAGER)
(336) 339-9671
Entity
Organization
Contact information
Practice address
10201 ARCOS AVE STE 104, ESTERO, FL 33928-9460
(239) 955-4778
(321) 638-4559
Mailing address
8695 CONNECTICUT ST STE E, MERRILLVILLE, IN 46410-6240
(321) 225-8001
(321) 225-4046
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016079800
—
FL
Enumeration date
10/30/2015
Last updated
09/02/2025
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