Healthcare Provider Details

I. General information

NPI: 1386649127
Provider Name (Legal Business Name): MASTERCARE MEDICAL SUPPLIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 FONTAINEBLEAU BLVD STE 1N5
MIAMI FL
33172-4511
US

IV. Provider business mailing address

175 FONTAINEBLEAU BLVD STE 1N5
MIAMI FL
33172-4511
US

V. Phone/Fax

Practice location:
  • Phone: 305-229-1770
  • Fax: 305-229-2857
Mailing address:
  • Phone: 305-229-1770
  • Fax: 305-229-2857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number149
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number32:00287
License Number StateFL

VIII. Authorized Official

Name: MRS. ROSAURA A SOSA
Title or Position: PRESIDENT
Credential:
Phone: 305-229-1770