Healthcare Provider Details

I. General information

NPI: 1891995908
Provider Name (Legal Business Name): O2 RESPIRATORY MEDICAL EQUIPMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2007
Last Update Date: 11/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

364 WILSHIRE BLVD
CASSELBERRY FL
32707-5370
US

IV. Provider business mailing address

500 N KIMBALL AVE STE 106
SOUTHLAKE TX
76092-6683
US

V. Phone/Fax

Practice location:
  • Phone: 407-834-7950
  • Fax: 407-834-7952
Mailing address:
  • Phone: 817-695-4123
  • Fax: 817-652-9394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number326421
License Number StateFL

VIII. Authorized Official

Name: MR. ISRAEL NAVARRO
Title or Position: PRESIDENT
Credential: MBA
Phone: 817-845-4224