Healthcare Provider Details

I. General information

NPI: 1235061946
Provider Name (Legal Business Name): DME MEDICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6824 283RD ST E
MYAKKA CITY FL
34251-3300
US

IV. Provider business mailing address

6824 283RD ST E
MYAKKA CITY FL
34251-3300
US

V. Phone/Fax

Practice location:
  • Phone: 937-504-3049
  • Fax:
Mailing address:
  • Phone: 937-504-3049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DEVA MARIE ELLIS
Title or Position: APRN, CLINICAL DIRECTOR
Credential: APRN
Phone: 937-504-3049