MEDICARE: DYNAMIC MEDICAL SUPPLY USA 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

General Provider Information

NPI Number	:	1619997186
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DYNAMIC MEDICAL SUPPLY USA INC

Provider Business Mailing Address
First Line	:	1254 E 4TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-3502
Country	:	US
Telephone Number	:	305-884-1781
Fax Number	:	305-884-1781

Provider Business Practice Location Address
First Line	:	1254 E 4TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-3502
Country	:	US
Telephone Number	:	305-884-1781
Fax Number	:	305-884-1781

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. NELSON NUNEZ
Credential	:
Telephone Number	:	305-884-1781

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	08/22/2020

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