Healthcare Provider Details
I. General information
NPI: 1740114891
Provider Name (Legal Business Name): ACTIVE PATH MEDICAL SUPPLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8750 NW 38TH ST APT 151
SUNRISE FL
33351-1503
US
IV. Provider business mailing address
950 S PINE ISLAND RD STE 150A
PLANTATION FL
33324-3918
US
V. Phone/Fax
- Phone: 954-275-9869
- Fax:
- Phone:
- Fax:
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:
ARSHAD
JAMAL
Title or Position: OWNER
Credential:
Phone: 954-275-9869