MEDICARE: M.I.R. MEDICAL EQUIPMENTS

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)	1312389	FL

General Provider Information

NPI Number	:	1184631285
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M.I.R. MEDICAL EQUIPMENTS

Provider Business Mailing Address
First Line	:	801 S FEDERAL HWY
Second Line	:	STE 815
City	:	DANIA
State	:	FL
Zip	:	33004-4374
Country	:	US
Telephone Number	:	954-925-7425
Fax Number	:	954-925-5363

Provider Business Practice Location Address
First Line	:	801 S FEDERAL HWY
Second Line	:	STE 815
City	:	DANIA
State	:	FL
Zip	:	33004-4374
Country	:	US
Telephone Number	:	954-925-7425
Fax Number	:	954-925-5363

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARISEL D RIVERON
Credential	:
Telephone Number	:	954-925-7425

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	08/22/2020

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