Provider Demographics
NPI:1487702056
Name:AMERICAN BIOCARE COMPANY, INC.
Entity type:Organization
Organization Name:AMERICAN BIOCARE COMPANY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-936-1616
Mailing Address - Street 1:7045 N ARMENIA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-5252
Mailing Address - Country:US
Mailing Address - Phone:813-936-1616
Mailing Address - Fax:813-936-1818
Practice Address - Street 1:7045 N ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-5252
Practice Address - Country:US
Practice Address - Phone:813-936-1616
Practice Address - Fax:813-936-1818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL699332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004421200Medicaid
FL004421200Medicaid