Healthcare Provider Details

I. General information

NPI: 1720014129
Provider Name (Legal Business Name): D.D.A. MEDICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 WEST 49TH STREET SUITE 731
HIALEAH FL
33012
US

IV. Provider business mailing address

1840 WEST 49TH STREET SUITE 731
HIALEAH FL
33012
US

V. Phone/Fax

Practice location:
  • Phone: 305-825-2730
  • Fax: 305-698-9607
Mailing address:
  • Phone: 305-825-2730
  • Fax: 305-698-9607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1313276
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number326512
License Number StateFL

VIII. Authorized Official

Name: MR. DERIS REYES
Title or Position: PRESIDENT
Credential:
Phone: 786-312-4230