Healthcare Provider Details

I. General information

NPI: 1821003401
Provider Name (Legal Business Name): MEDICAL EQUIPMENT GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 11/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3109 W HALLANDALE BEACH BLVD SUITE 101
HALLANDALE BEACH FL
33009-5148
US

IV. Provider business mailing address

3109 W HALLANDALE BEACH BLVD SUITE 101
HALLANDALE BEACH FL
33009-5148
US

V. Phone/Fax

Practice location:
  • Phone: 954-964-8754
  • Fax: 954-964-8764
Mailing address:
  • Phone: 954-964-8754
  • Fax: 954-964-8764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1312519
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number3204164
License Number StateFL

VIII. Authorized Official

Name: MR. ANDY HERNANDEZ
Title or Position: PRESIDENT
Credential:
Phone: 954-964-8754