Healthcare Provider Details

I. General information

NPI: 1851324511
Provider Name (Legal Business Name): GOLDSTAR MEDICAL & HOSPITAL SUPPLY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

7911 NW 72ND AVE 220A
MEDLEY FL
33166-2227
US

IV. Provider business mailing address

7911 NW 72ND AVE 220A
MEDLEY FL
33166-2227
US

V. Phone/Fax

Practice location:
  • Phone: 305-231-7177
  • Fax: 305-402-3836
Mailing address:
  • Phone: 305-231-7177
  • Fax: 305-402-3836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1844
License Number StateFL

VIII. Authorized Official

Name: CAROLINE E CHAVEZ
Title or Position: PRESIDENT
Credential:
Phone: 305-231-7177