Healthcare Provider Details

I. General information

NPI: 1326039090
Provider Name (Legal Business Name): KIRSIE ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 08/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

881 103RD AVE N SUITE #5
NAPLES FL
34108-3200
US

IV. Provider business mailing address

881 103RD AVE N SUITE #5
NAPLES FL
34108-3200
US

V. Phone/Fax

Practice location:
  • Phone: 239-597-8805
  • Fax: 239-597-6558
Mailing address:
  • Phone: 239-597-8805
  • Fax: 239-597-6558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberAHCA 1156
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number1156
License Number StateFL

VIII. Authorized Official

Name: MR. SUSAN J SCHNACK
Title or Position: PRESIDENT
Credential:
Phone: 239-597-8805