MEDICARE: PROMED MEDICAL EQUIPMENT & SUPPLY, 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	332B00000X	Durable Medical Equipment & Medical Supplies	1312445	FL

General Provider Information

NPI Number	:	1518924034
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROMED MEDICAL EQUIPMENT & SUPPLY, INC.

Provider Business Mailing Address
First Line	:	1490 W 49TH PL
Second Line	:	SUITE 512
City	:	MIAMI
State	:	FL
Zip	:	33012-3148
Country	:	US
Telephone Number	:	305-817-3139
Fax Number	:

Provider Business Practice Location Address
First Line	:	1490 W 49TH PL
Second Line	:	SUITE 512
City	:	MIAMI
State	:	FL
Zip	:	33012-3148
Country	:	US
Telephone Number	:	305-817-3139
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. SAMUEL GARCIA
Credential	:
Telephone Number	:	305-817-3139

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	08/22/2020

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