Healthcare Provider Details

I. General information

NPI: 1932541646
Provider Name (Legal Business Name): STYMCO MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2013
Last Update Date: 05/08/2020
Certification Date: 05/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8176 WOODLAND CENTER BLVD
TAMPA FL
33614-2418
US

IV. Provider business mailing address

8176 WOODLAND CENTER BLVD
TAMPA FL
33614-2418
US

V. Phone/Fax

Practice location:
  • Phone: 813-922-3150
  • Fax: 813-925-4753
Mailing address:
  • Phone: 813-922-3150
  • Fax: 813-925-4753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1313948
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number1313948
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code332BD1200X
TaxonomyDialysis Equipment & Supplies (DME)
License Number1313948
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number1313948
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number1313948
License Number StateFL

VIII. Authorized Official

Name: ANA MARIA VARGAS
Title or Position: VICE PRESIDENT
Credential:
Phone: 813-922-3150