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General NPI Number Information
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NPI Number | 1386775724
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Entity Type | Organization
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Legal Business Name | PRESTIGE PROFESSIONAL SERVICE CORP
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 12355 SW 129TH CT SUITE 102
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City | MIAMI
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State | FL
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Zip | 33186-6406
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Country | US
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Telephone | 786-242-9739
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Fax |
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Provider Business Mailing Address
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Address Line | 12355 SW 129TH CT SUITE 102
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City | MIAMI
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State | FL
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Zip | 33186-6406
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Country | US
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Telephone | 786-242-9739
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. YOSAEL ACOSTA
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Credential |
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Telephone | 786-970-4119
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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 | FL
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