Healthcare Provider Details

I. General information

NPI: 1790218212
Provider Name (Legal Business Name): DOCTORS CHOICE MEDICAL SUPPLIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2017
Last Update Date: 04/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 E SAMPLE RD STE 5
POMPANO BEACH FL
33064-5161
US

IV. Provider business mailing address

1001 E SAMPLE RD STE 5
POMPANO BEACH FL
33064-5161
US

V. Phone/Fax

Practice location:
  • Phone: 786-838-9476
  • Fax: 305-397-1382
Mailing address:
  • Phone: 786-838-9476
  • Fax: 305-397-1382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CARLOS A MENDEZ DELGADO
Title or Position: MANAGER
Credential:
Phone: 786-838-9476