Provider Demographics
NPI:1285726539
Name:SOUTHEASTERN MEDICAL EQUIPMENT
Entity type:Organization
Organization Name:SOUTHEASTERN MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:IGNACIO
Authorized Official - Middle Name:LANEL
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-819-3858
Mailing Address - Street 1:2980 W 84TH ST
Mailing Address - Street 2:BAY 10
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4916
Mailing Address - Country:US
Mailing Address - Phone:305-819-3858
Mailing Address - Fax:305-819-3880
Practice Address - Street 1:2980 W 84TH ST
Practice Address - Street 2:BAY 10
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-4916
Practice Address - Country:US
Practice Address - Phone:305-819-3858
Practice Address - Fax:305-819-3880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1313040332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1066510001Medicare ID - Type UnspecifiedPROVIDER NUMBER