Healthcare Provider Details

I. General information

NPI: 1083669014
Provider Name (Legal Business Name): MAJESTIC MEDICAL SUPPLIES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6365 TAFT ST 3005
HOLLYWOOD FL
33024-5952
US

IV. Provider business mailing address

6365 TAFT ST 3005
HOLLYWOOD FL
33024-5952
US

V. Phone/Fax

Practice location:
  • Phone: 954-987-1975
  • Fax: 954-987-1355
Mailing address:
  • Phone: 954-987-1975
  • Fax: 954-987-1355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. GREGORIO GONZALES
Title or Position: OWNER
Credential:
Phone: 305-298-7645