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General NPI Number Information
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NPI Number | 1306884010
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Entity Type | Organization
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Legal Business Name | SOUTHEAST OXYGEN, INC.
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1829 S DIXIE HWY
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City | POMPANO BEACH
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State | FL
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Zip | 33060-8916
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Country | US
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Telephone | 954-941-1288
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Fax | 954-941-3380
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Provider Business Mailing Address
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Address Line | 1829 S DIXIE HWY
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City | POMPANO BEACH
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State | FL
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Zip | 33060-8916
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Country | US
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Telephone | 954-941-1288
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Fax | 954-941-3380
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | SUSAN D MAJAVA
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Credential |
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Telephone | 954-303-7012
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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 | 1396
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License Number State | FL
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