Healthcare Provider Details

I. General information

NPI: 1285705079
Provider Name (Legal Business Name): CITICARE MEDICAL SUPPLIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 N HIGHWAY 27 C1
MINNEOLA FL
34715-7707
US

IV. Provider business mailing address

303 N HIGHWAY 27 C1
MINNEOLA FL
34715-7707
US

V. Phone/Fax

Practice location:
  • Phone: 352-243-9777
  • Fax: 352-243-9717
Mailing address:
  • Phone: 352-243-9777
  • Fax: 352-243-9717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberP06000129372
License Number StateFL

VIII. Authorized Official

Name: MS. SHARON JENNIFER CREARY
Title or Position: PRESIDENT
Credential:
Phone: 352-243-9777