Healthcare Provider Details

I. General information

NPI: 1336375963
Provider Name (Legal Business Name): AXIS MEDICAL SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2009
Last Update Date: 12/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 S DILLARD ST
WINTER GARDEN FL
34787-3580
US

IV. Provider business mailing address

PO BOX 692631
ORLANDO FL
32869-2631
US

V. Phone/Fax

Practice location:
  • Phone: 407-601-4937
  • Fax: 321-445-5450
Mailing address:
  • Phone: 407-601-4937
  • Fax: 321-445-5450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number326762
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. DIANA C PARRA
Title or Position: MANAGER
Credential:
Phone: 407-601-4937