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General NPI Number Information
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NPI Number | 1306560149
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Entity Type | Organization
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Legal Business Name | DYNAMIC MEDICAL SERVICES, LLD
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Dates
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Enumeration Date | 09/26/2022
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 871 CORONADO CENTER DR STE 202
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City | HENDERSON
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State | NV
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Zip | 89052-3977
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Country | US
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Telephone | 702-545-8260
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Fax |
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Provider Business Mailing Address
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Address Line | 871 CORONADO CENTER DR STE 202
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City | HENDERSON
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State | NV
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Zip | 89052-3977
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL SALVATORE AQUINO
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Credential |
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Telephone | 702-482-4130
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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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