Provider Demographics
NPI:1063433423
Name:GROWN MEDICAL EQUIPMENT
Entity type:Organization
Organization Name:GROWN MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTIESTEBAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-231-1770
Mailing Address - Street 1:11300 N.W. 87 COURT
Mailing Address - Street 2:SUITE 157
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018
Mailing Address - Country:US
Mailing Address - Phone:305-231-1770
Mailing Address - Fax:305-231-1771
Practice Address - Street 1:11300 N.W. 87 COURT
Practice Address - Street 2:SUITE 157
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018
Practice Address - Country:US
Practice Address - Phone:305-231-1770
Practice Address - Fax:305-231-1771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies