Healthcare Provider Details

I. General information

NPI: 1689525719
Provider Name (Legal Business Name): MEDIMARKET EXPRESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2026
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13740 ARTESA BELL DR
RIVERVIEW FL
33579-2398
US

IV. Provider business mailing address

13740 ARTESA BELL DR
RIVERVIEW FL
33579-2398
US

V. Phone/Fax

Practice location:
  • Phone: 860-469-0877
  • Fax:
Mailing address:
  • Phone: 860-469-0877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MARIO DEANDRE CHAPPELL
Title or Position: OWNER
Credential:
Phone: 860-469-0877