Healthcare Provider Details

I. General information

NPI: 1407571565
Provider Name (Legal Business Name): HLL MED SUPPLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2022
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14050 SW 84 ST SUITE 206
MIAMI FL
33183
US

IV. Provider business mailing address

14050 SW 84 ST SUITE 206
MIAMI FL
33183
US

V. Phone/Fax

Practice location:
  • Phone: 786-438-7806
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: OGHENEVWOGAGA OPHORI
Title or Position: OWNER
Credential:
Phone: 786-438-7806