MEDICARE: INDIAN MEDICAL EQUIPMENT, CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)	1186	FL
2	332BX2000X	Oxygen Equipment & Supplies (DME)	32:02617	FL

General Provider Information

NPI Number	:	1174519169
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INDIAN MEDICAL EQUIPMENT, CORP

Provider Business Mailing Address
First Line	:	3750 W 16TH AVE
Second Line	:	SUITE 132-AU
City	:	HIALEAH
State	:	FL
Zip	:	33012-4654
Country	:	US
Telephone Number	:	305-556-7702
Fax Number	:	305-556-7122

Provider Business Practice Location Address
First Line	:	3750 W 16TH AVE
Second Line	:	SUITE 132-AU
City	:	HIALEAH
State	:	FL
Zip	:	33012-4654
Country	:	US
Telephone Number	:	305-556-7702
Fax Number	:	305-556-7122

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NIEVES C VALDEZ
Credential	:
Telephone Number	:	305-556-7702

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	08/22/2020

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