Healthcare Provider Details
I. General information
NPI: 1659563823
Provider Name (Legal Business Name): PDARBY OF FLORIDA INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/13/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1306 LAKE LUCERNE WAY STE 303
BRANDON FL
33511-2293
US
IV. Provider business mailing address
PO BOX 3714
BRANDON FL
33509-3714
US
V. Phone/Fax
- Phone: 813-514-7174
- Fax: 813-661-0456
- Phone: 813-514-7174
- Fax: 813-661-0456
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BD1200X |
| Taxonomy | Dialysis Equipment & Supplies (DME) |
| License Number | |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BN1400X |
| Taxonomy | Nursing Facility Supplies (DME) |
| License Number | |
| License Number State | FL |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | |
| License Number State | FL |
VIII. Authorized Official
Name: MS.
PATRICIA
ANN
DARBY
Title or Position: CEO/OWNER
Credential:
Phone: 813-514-7174