Healthcare Provider Details

I. General information

NPI: 1366197535
Provider Name (Legal Business Name): LR MEDISUPPORT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2022
Last Update Date: 06/08/2023
Certification Date: 06/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19790 W DIXIE HWY STE 903
AVENTURA FL
33180-2298
US

IV. Provider business mailing address

19790 W DIXIE HWY STE 903
AVENTURA FL
33180-2298
US

V. Phone/Fax

Practice location:
  • Phone: 800-531-5920
  • Fax:
Mailing address:
  • Phone: 800-531-5920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: ANGIE MORIN
Title or Position: CEO
Credential:
Phone: 800-531-5920