Organization
SOUTH BEACH ORTHOTICS & PROSTHETICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK SELLECK (OWNER / PRESIDENT)
(561) 394-4200
Entity
Organization
Contact information
Practice address
4735 PALM AVE, HIALEAH, FL 33012-4037
(561) 394-4200
(561) 394-4422
Mailing address
4147 SUN N LAKE BLVD, SEBRING, FL 33872-2131
(305) 672-9393
(305) 675-3706
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102101600
—
FL
Enumeration date
02/25/2009
Last updated
07/06/2023
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