MEDICARE: INSUA MEDICAL ASSOCIATION 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	332B00000X	Durable Medical Equipment & Medical Supplies		FL

General Provider Information

NPI Number	:	1215069927
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSUA MEDICAL ASSOCIATION CORP

Provider Business Mailing Address
First Line	:	11890 SW 8TH ST
Second Line	:	SUITE 212
City	:	MIAMI
State	:	FL
Zip	:	33184-1743
Country	:	US
Telephone Number	:	305-221-0070
Fax Number	:	305-221-0071

Provider Business Practice Location Address
First Line	:	11890 SW 8TH ST
Second Line	:	SUITE 212
City	:	MIAMI
State	:	FL
Zip	:	33184-1743
Country	:	US
Telephone Number	:	305-221-0070
Fax Number	:	305-221-0071

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. MAYRA INSUA
Credential	:
Telephone Number	:	786-299-3140

Provider Enumeration Date	:	03/09/2007
Last Update Date	:	12/31/2007

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