Healthcare Provider Details
I. General information
NPI: 1821134073
Provider Name (Legal Business Name): SOUTH RIVER MEDICAL EQUIPMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8232 NW SOUTH RIVER DR
MEDLEY FL
33166-7452
US
IV. Provider business mailing address
8232 NW SOUTH RIVER DR
MEDLEY FL
33166-7452
US
V. Phone/Fax
- Phone: 305-863-3755
- Fax: 305-863-3756
- Phone: 305-863-3755
- Fax: 305-863-3756
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:
ORELVIS
FIGUEROA
Title or Position: PRESIDENT
Credential:
Phone: 305-863-3755