Healthcare Provider Details

I. General information

NPI: 1396841185
Provider Name (Legal Business Name): CREATIVE MEDICAL SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 05/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8010 W. 23RD AVE STE #1
HIALEAH FL
33016
US

IV. Provider business mailing address

8010 W. 23RD AVE STE #1
HIALEAH FL
33016-5561
US

V. Phone/Fax

Practice location:
  • Phone: 305-820-0650
  • Fax: 305-362-1077
Mailing address:
  • Phone: 305-820-0650
  • Fax: 305-362-1077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1314529
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number StateFL

VIII. Authorized Official

Name: MRS. TAMARA A FROST
Title or Position: CEO
Credential:
Phone: 714-630-1716