Provider Demographics
NPI:1548529829
Name:BIG TIME BRACE INC
Entity type:Organization
Organization Name:BIG TIME BRACE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STOCKHOLDER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:A
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:II
Authorized Official - Credentials:STOCK HOLDER
Authorized Official - Phone:919-809-3808
Mailing Address - Street 1:747 PONCE DE LEON BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2049
Mailing Address - Country:US
Mailing Address - Phone:919-809-3808
Mailing Address - Fax:305-885-0544
Practice Address - Street 1:747 PONCE DE LEON BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134
Practice Address - Country:US
Practice Address - Phone:919-809-3808
Practice Address - Fax:305-885-0544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-08
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies