Healthcare Provider Details
I. General information
NPI: 1265308324
Provider Name (Legal Business Name): LAS MERCEDES MEDICAL SUPPLIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/15/2025
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7399 NW 74TH ST
MEDLEY FL
33166-2409
US
IV. Provider business mailing address
6355 NW 36TH ST EAST BUILDING, SUITE 1100
VIRGINIA GARDENS FL
33166-7009
US
V. Phone/Fax
- Phone: 786-401-7301
- Fax: 786-431-5975
- Phone: 786-233-6981
- Fax: 786-322-2317
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JORGE
RAAD
Title or Position: OWNER
Credential:
Phone: 786-233-6981