Organization
SOUTH BROWAID BRACE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VINCENT T PETTI LO (OWNER)
(954) 922-9061
Entity
Organization
Contact information
Practice address
3500 TYLER STREET, HOLLYWOOD, FL 33021
(954) 922-9061
(954) 458-8611
Mailing address
3500 TYLER STREET, HOLLYWOOD, FL 33021
(954) 922-9061
(954) 458-8611
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
FL
Other
Enumeration date
11/01/2006
Last updated
08/22/2020
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