Healthcare Provider Details
I. General information
NPI: 1801026703
Provider Name (Legal Business Name): CMO MEDICAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/26/2009
Last Update Date: 07/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6065 IBIS ST
SARASOTA FL
34241-9284
US
IV. Provider business mailing address
6065 IBIS ST
SARASOTA FL
34241-9284
US
V. Phone/Fax
- Phone: 941-929-0910
- Fax: 941-927-7277
- Phone: 941-929-0910
- Fax: 941-927-7277
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
TODD
M
RINCON
Title or Position: VICE-PRESIDENT
Credential:
Phone: 941-586-1006