Provider Demographics
NPI:1588119382
Name:MED ASSURE LLC
Entity type:Organization
Organization Name:MED ASSURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLEX
Authorized Official - Middle Name:
Authorized Official - Last Name:SAINTVIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-505-2064
Mailing Address - Street 1:801 NE 167TH ST
Mailing Address - Street 2:SUITE 307
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162
Mailing Address - Country:US
Mailing Address - Phone:954-839-4952
Mailing Address - Fax:305-692-0008
Practice Address - Street 1:801 NE 167TH ST
Practice Address - Street 2:SUITE 307
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162
Practice Address - Country:US
Practice Address - Phone:954-505-2064
Practice Address - Fax:305-692-0008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-22
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7575390001Medicare NSC