Healthcare Provider Details

I. General information

NPI: 1295286888
Provider Name (Legal Business Name): US MEDICAL INTERNATIONAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2016
Last Update Date: 10/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6989 NW 82ND AVE
MIAMI FL
33166-2774
US

IV. Provider business mailing address

6989 NW 82ND AVE
MIAMI FL
33166-2774
US

V. Phone/Fax

Practice location:
  • Phone: 305-468-3248
  • Fax: 305-468-3242
Mailing address:
  • Phone: 305-468-3248
  • Fax: 305-468-3242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberL09000043438
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License NumberL09000043438
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License NumberL09000043438
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberL09000043438
License Number StateFL

VIII. Authorized Official

Name: MR. ANDRES GOMEZ
Title or Position: DIRECTOR
Credential:
Phone: 305-987-4212