Provider Demographics
NPI:1386712909
Name:XT MEDICAL SUPPLIES CORP
Entity type:Organization
Organization Name:XT MEDICAL SUPPLIES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:XIOMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAPANES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-718-8299
Mailing Address - Street 1:8355 NW 74TH ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:MEDLEY
Mailing Address - State:FL
Mailing Address - Zip Code:33166-2323
Mailing Address - Country:US
Mailing Address - Phone:305-718-8299
Mailing Address - Fax:
Practice Address - Street 1:8355 NW 74TH ST
Practice Address - Street 2:SUITE E
Practice Address - City:MEDLEY
Practice Address - State:FL
Practice Address - Zip Code:33166-2323
Practice Address - Country:US
Practice Address - Phone:305-718-8299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL332B00000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5964260001Medicare NSC