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General NPI Number Information
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NPI Number | 1265253470
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Entity Type | Organization
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Legal Business Name | THE DME BOUTIQUE LLC
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Dates
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Enumeration Date | 10/21/2024
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 2880 S OSCEOLA AVE
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City | ORLANDO
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State | FL
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Zip | 32806-5431
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Country | US
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Telephone | 407-993-6323
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Fax | 954-272-7111
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Provider Business Mailing Address
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Address Line | 8353 PINES BLVD
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6607
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Country | US
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Telephone | 954-505-4411
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Fax | 954-272-7111
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Authorized Official
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Title or Position | OWNER
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Name | JOHN ALMONACID
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Credential |
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Telephone | 954-261-7081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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