Healthcare Provider Details

I. General information

NPI: 1942293931
Provider Name (Legal Business Name): PACIFIC MEDICAL CARE & RENTAL EQUIPMENT CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1651 W 37 ST SUITE 308
HIALEAH FL
33012
US

IV. Provider business mailing address

1651 W 37 ST SUITE 308
HIALEAH FL
33012
US

V. Phone/Fax

Practice location:
  • Phone: 305-556-2162
  • Fax: 305-818-0591
Mailing address:
  • Phone: 305-556-2162
  • Fax: 305-818-0591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number589
License Number StateFL

VIII. Authorized Official

Name: MS. EFRAN OLAMENDIS SUAREZ
Title or Position: OWNER
Credential:
Phone: 305-267-9111