Healthcare Provider Details

I. General information

NPI: 1720528623
Provider Name (Legal Business Name): FLORIDA ALL MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2017
Last Update Date: 02/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N STATE ROAD 7 SUITE 104
MARGATE FL
33063-4520
US

IV. Provider business mailing address

100 N STATE ROAD 7 SUITE 104
MARGATE FL
33063-4520
US

V. Phone/Fax

Practice location:
  • Phone: 954-532-4122
  • Fax: 954-657-8149
Mailing address:
  • Phone: 954-532-4122
  • Fax: 954-657-8149

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 State
# 3
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code335G00000X
TaxonomyMedical Foods Supplier
License Number
License Number State

VIII. Authorized Official

Name: MRS. YESSYKA BENITEZ COSMIOS
Title or Position: PRESIDENT
Credential:
Phone: 954-590-8931