Healthcare Provider Details

I. General information

NPI: 1073095907
Provider Name (Legal Business Name): NKANSA-GYANE INDUSTRIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2018
Last Update Date: 09/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4425 PARK BREEZE COURT
ORLANDO FL
32808-1021
US

IV. Provider business mailing address

4425 PARK BREEZE COURT
ORLANDO FL
32808-1021
US

V. Phone/Fax

Practice location:
  • Phone: 407-751-2277
  • Fax: 407-393-5520
Mailing address:
  • Phone: 407-751-2277
  • Fax: 407-393-5520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. EDWARD NKANSA-GYNE
Title or Position: CEO
Credential:
Phone: 407-751-2277