Healthcare Provider Details

I. General information

NPI: 1073561726
Provider Name (Legal Business Name): IFA MEDICAL SUPPLY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1833 WEST FLAGLER STREET SUITE #200
MIAMI FL
33135
US

IV. Provider business mailing address

1833 WEST FLAGLER STREET SUITE #200
MIAMI FL
33135
US

V. Phone/Fax

Practice location:
  • Phone: 305-643-5100
  • Fax: 305-643-3600
Mailing address:
  • Phone: 305-643-5100
  • Fax: 305-643-3600

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: LUIS AGUILAR
Title or Position: PRESIDENT
Credential:
Phone: 305-643-5100