Healthcare Provider Details

I. General information

NPI: 1396140737
Provider Name (Legal Business Name): ALLY MEDICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2014
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 N BROAD ST STE A
BREVARD NC
28712-4463
US

IV. Provider business mailing address

4951B E ADAMO DR SUITE 220
TAMPA FL
33605-5924
US

V. Phone/Fax

Practice location:
  • Phone: 866-684-2507
  • Fax: 866-695-2183
Mailing address:
  • Phone: 866-684-2507
  • Fax: 866-695-2183

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 Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. TODD ELDER CIANFROCCA
Title or Position: CEO
Credential:
Phone: 813-785-8988