Healthcare Provider Details

I. General information

NPI: 1144328048
Provider Name (Legal Business Name): SOUTH PACIFIC MEDICAL EQUIPMENT CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 SW 1ST ST SUITE 101
MIAMI FL
33135-1960
US

IV. Provider business mailing address

1800 SW 1ST ST SUITE 101
MIAMI FL
33135-1960
US

V. Phone/Fax

Practice location:
  • Phone: 305-642-0180
  • Fax: 305-642-0190
Mailing address:
  • Phone: 305-642-0180
  • Fax: 305-642-0190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH 23410
License Number StateFL

VIII. Authorized Official

Name: JUAN C ARAGON
Title or Position: PRESIDENT
Credential:
Phone: 305-642-0180