Healthcare Provider Details

I. General information

NPI: 1619295672
Provider Name (Legal Business Name): GHD DURABLE MEDICAL EQUIPMENTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2010
Last Update Date: 05/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E MONUMENT AVE SUITE 311
KISSIMMEE FL
34741-5762
US

IV. Provider business mailing address

111 E MONUMENT AVE SUITE 311
KISSIMMEE FL
34741-5762
US

V. Phone/Fax

Practice location:
  • Phone: 407-962-8666
  • Fax:
Mailing address:
  • Phone: 407-962-8666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. DIANA D BARLETTA
Title or Position: PRESIDENT
Credential:
Phone: 407-962-8666