Organization
BREVARD PROSTHETICS & ORTHOTICS, INC
Active
Parent organization
BREVARD PROSTHETICS & ORTHOTICS, INC.
Other names
Brevard Prosthetics Inc.
Organization subpart
Yes
Provider details
NPI number
Legal business name
BREVARD PROSTHETICS & ORTHOTICS, INC.
Authorized official
MR. SUMESH SAXENA (MEMBER)
(219) 648-2644
Entity
Organization
Contact information
Practice address
966 US HIGHWAY 1, ROCKLEDGE, FL 32955-2128
(321) 638-0262
(321) 638-4559
Mailing address
3803 E LINCOLN HWY, MERRILLVILLE, IN 46410-5809
(219) 648-2644
(219) 228-8510
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
FL
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009958700
—
FL
Enumeration date
02/20/2007
Last updated
03/28/2023
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