Provider Demographics
NPI:1588891089
Name:MEDTINO INCORPORATED
Entity type:Organization
Organization Name:MEDTINO INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:TOWSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-486-5010
Mailing Address - Street 1:3601 W COMMERCIAL BLVD
Mailing Address - Street 2:SUITE 15
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3300
Mailing Address - Country:US
Mailing Address - Phone:954-486-5010
Mailing Address - Fax:
Practice Address - Street 1:3601 W COMMERCIAL BLVD
Practice Address - Street 2:SUITE 15
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-3300
Practice Address - Country:US
Practice Address - Phone:954-486-5010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-11
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6277890001Medicare NSC