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General NPI Number Information
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NPI Number | 1023907573
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Entity Type | Organization
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Legal Business Name | DE PASO MEDICAL SUPPLY CORPORATION
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 934 N MAGNOLIA AVE # 101
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City | ORLANDO
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State | FL
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Zip | 32803-3840
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Country | US
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Telephone | 407-704-1076
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Fax | 407-610-5353
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Provider Business Mailing Address
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Address Line | 934 N MAGNOLIA AVE # 101
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City | ORLANDO
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State | FL
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Zip | 32803-3840
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Country | US
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Telephone | 407-704-1076
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Fax | 407-610-5353
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Authorized Official
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Title or Position | CEO
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Name | MARCUS JEAN
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Credential |
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Telephone | 305-761-7662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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