Provider Demographics
NPI:1699097816
Name:DIABETES MADE EZ, LLC
Entity type:Organization
Organization Name:DIABETES MADE EZ, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:DECHENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-750-5014
Mailing Address - Street 1:1700 S DIXIE HWY
Mailing Address - Street 2:STE. 303
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-7452
Mailing Address - Country:US
Mailing Address - Phone:561-750-5014
Mailing Address - Fax:561-750-5016
Practice Address - Street 1:1700 S DIXIE HWY
Practice Address - Street 2:STE. 303
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-7452
Practice Address - Country:US
Practice Address - Phone:561-750-5014
Practice Address - Fax:561-750-5016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-16
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6424320001Medicare NSC