Provider Demographics
NPI:1316980147
Name:ILE A LA SAKE CORP.
Entity type:Organization
Organization Name:ILE A LA SAKE CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KADIR
Authorized Official - Middle Name:
Authorized Official - Last Name:AYUB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-201-3960
Mailing Address - Street 1:19201 COLLINS AVE
Mailing Address - Street 2:10
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2202
Mailing Address - Country:US
Mailing Address - Phone:305-932-7661
Mailing Address - Fax:305-932-7647
Practice Address - Street 1:19201 COLLINS AVE
Practice Address - Street 2:10
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-2202
Practice Address - Country:US
Practice Address - Phone:305-932-7661
Practice Address - Fax:305-932-7647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL332BX2000X332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies