MEDICARE: SAGUA MEDICAL SUPPLIES

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)	3130	FL

General Provider Information

NPI Number	:	1841261724
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAGUA MEDICAL SUPPLIES

Provider Business Mailing Address
First Line	:	6555 NW 36 ST # 311
Second Line	:
City	:	VIRGINIA GARDENS
State	:	FL
Zip	:	33166-6975
Country	:	US
Telephone Number	:	305-870-0611
Fax Number	:	305-870-0612

Provider Business Practice Location Address
First Line	:	6555 NW 36 ST # 311
Second Line	:
City	:	VIRGINIA GARDENS
State	:	FL
Zip	:	33166-6975
Country	:	US
Telephone Number	:	305-870-0611
Fax Number	:	305-870-0612

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. MARIA PEREZ
Credential	:
Telephone Number	:	305-870-0611

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	08/22/2020

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Directions to “SAGUA MEDICAL SUPPLIES ” Practice Location

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