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General NPI Number Information
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NPI Number | 1265441406
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Entity Type | Organization
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Legal Business Name | ST JUDE MEDICAL EQUIPMENT,INC
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 10871 SW 188TH ST STE 29
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City | CUTLER BAY
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State | FL
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Zip | 33157-6800
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Country | US
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Telephone | 305-969-8157
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Fax | 305-969-8158
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Provider Business Mailing Address
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Address Line | 10871 SW 188TH ST STE 29
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City | CUTLER BAY
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State | FL
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Zip | 33157-6800
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Country | US
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Telephone | 305-969-8157
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Fax | 305-969-8158
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Authorized Official
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Title or Position | PRESIDENT
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Name | FERNANDO J VALDERAS
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Credential |
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Telephone | 305-969-8157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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