MEDICARE: SELECT MEDICAL SOLUTIONS LLC

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	:	1851880132
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SELECT MEDICAL SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	PO BOX 471
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34682-0471
Country	:	US
Telephone Number	:	833-767-8367
Fax Number	:

Provider Business Practice Location Address
First Line	:	4575 WHITTON WAY
Second Line	:	UNIT# 1119
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34653
Country	:	US
Telephone Number	:	833-767-8367
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	MR. DAN ACEVEDO
Credential	:
Telephone Number	:	833-767-8367

Provider Enumeration Date	:	05/02/2018
Last Update Date	:	08/20/2018

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