MEDICARE: OCEAN CONVERSIONS & MOBILITY OF FT MYERS, INC

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	332BC3200X	Customized Equipment (DME)	1496	FL

General Provider Information

NPI Number	:	1467506584
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCEAN CONVERSIONS & MOBILITY OF FT MYERS, INC

Provider Business Mailing Address
First Line	:	5751 ZIP DR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33905-5035
Country	:	US
Telephone Number	:	239-936-6333
Fax Number	:	239-936-0909

Provider Business Practice Location Address
First Line	:	5751 ZIP DR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33905-5035
Country	:	US
Telephone Number	:	239-936-6333
Fax Number	:	239-936-0909

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JAMES PARKS
Credential	:
Telephone Number	:	954-942-6033

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	04/12/2011

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