Healthcare Provider Details

I. General information

NPI: 1063380756
Provider Name (Legal Business Name): CMS DISTRIBUTION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2025
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18851 NE 29TH AVE STE 450
AVENTURA FL
33180-2808
US

IV. Provider business mailing address

18851 NE 29TH AVE STE 450
AVENTURA FL
33180-2808
US

V. Phone/Fax

Practice location:
  • Phone: 877-992-6682
  • Fax:
Mailing address:
  • Phone: 877-992-6682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: SAMANTHA GARDNER
Title or Position: MGR
Credential:
Phone: 305-979-1781