Provider Demographics
NPI:1427157445
Name:MEDI-DEX MEDICAL EQUIPMENT CORP
Entity type:Organization
Organization Name:MEDI-DEX MEDICAL EQUIPMENT CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-822-0552
Mailing Address - Street 1:8010 W 23RD AVE
Mailing Address - Street 2:BAY #2
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5561
Mailing Address - Country:US
Mailing Address - Phone:305-822-0552
Mailing Address - Fax:305-822-0225
Practice Address - Street 1:8010 W 23RD AVE
Practice Address - Street 2:BAY #2
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5561
Practice Address - Country:US
Practice Address - Phone:305-822-0552
Practice Address - Fax:305-822-0225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL161332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0903680001Medicare ID - Type Unspecified