Healthcare Provider Details

I. General information

NPI: 1083782411
Provider Name (Legal Business Name): MSC QUALITY SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14169 SW 142ND AVE
MIAMI FL
33186-6795
US

IV. Provider business mailing address

14169 SW 142ND AVE
MIAMI FL
33186-6795
US

V. Phone/Fax

Practice location:
  • Phone: 305-238-5103
  • Fax: 305-238-9869
Mailing address:
  • Phone: 305-238-5103
  • Fax: 305-238-9869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. MELQUISEDEC CISNEROS MESA
Title or Position: PRESIDENT
Credential:
Phone: 305-238-5103