Healthcare Provider Details

I. General information

NPI: 1043243454
Provider Name (Legal Business Name): MEDLEY MEDICAL EQUIPMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7911 NW 72ND AVE STE 209B
MEDLEY FL
33166-2223
US

IV. Provider business mailing address

7911 NW 72ND AVE STE 209B
MEDLEY FL
33166-2223
US

V. Phone/Fax

Practice location:
  • Phone: 305-889-1923
  • Fax: 305-889-1925
Mailing address:
  • Phone: 305-889-1923
  • Fax: 305-889-1925

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: LAZARA AMAYA
Title or Position: PRESIDENT
Credential:
Phone: 305-889-1923