Provider Demographics
NPI:1396787016
Name:MIAMI MEDICAL SUPPLY & EQUIPMENT, CORP.
Entity type:Organization
Organization Name:MIAMI MEDICAL SUPPLY & EQUIPMENT, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAZARO
Authorized Official - Middle Name:M
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-264-2855
Mailing Address - Street 1:7105 SW 8TH ST
Mailing Address - Street 2:208
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4664
Mailing Address - Country:US
Mailing Address - Phone:305-264-2855
Mailing Address - Fax:305-264-2933
Practice Address - Street 1:7105 SW 8TH ST
Practice Address - Street 2:208
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4664
Practice Address - Country:US
Practice Address - Phone:305-264-2855
Practice Address - Fax:305-264-2933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1312809332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5451670001Medicare ID - Type UnspecifiedPROVIDER NUMBER