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General NPI Number Information
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NPI Number | 1134905706
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Entity Type | Organization
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Legal Business Name | BAY AREA DURABLE MEDICAL EQUIPMENT LLC
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Dates
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Enumeration Date | 09/07/2023
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 115 MARGARET ST STE D-2
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City | BRANDON
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State | FL
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Zip | 33511-5257
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Country | US
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Telephone | 813-708-7911
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Fax |
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Provider Business Mailing Address
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Address Line | 2105 ROANOKE SPRINGS DR
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City | RUSKIN
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State | FL
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Zip | 33570-6312
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Country | US
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Telephone | 813-585-7708
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DESHAE MARTIN
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Credential |
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Telephone | 813-679-5122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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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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