Healthcare Provider Details

I. General information

NPI: 1891436200
Provider Name (Legal Business Name): MEDICOR ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2022
Last Update Date: 04/07/2022
Certification Date: 04/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33853 SR 54 STE 101
ZEPHYRHILLS FL
33543-9105
US

IV. Provider business mailing address

PO BOX 1134
ODESSA FL
33556-1046
US

V. Phone/Fax

Practice location:
  • Phone: 800-250-4468
  • Fax: 813-930-6220
Mailing address:
  • Phone: 800-250-4468
  • Fax: 813-930-6220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: FELICIA DELGADO
Title or Position: MANAGER
Credential:
Phone: 800-250-4468