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General NPI Number Information
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NPI Number | 1457720575
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Entity Type | Organization
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Legal Business Name | MEDICAL EQUIPMENT AND SUPPLIES OF AMERICA LLC
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Dates
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Enumeration Date | 09/18/2015
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Last Update Date | 09/18/2015
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Provider Practice Location Address
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Address Line | 4301 FORTUNE PL SUITES H & J
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City | WEST MELBOURNE
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State | FL
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Zip | 32904-1510
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Country | US
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Telephone | 321-821-4535
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Fax | 866-727-2399
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Provider Business Mailing Address
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Address Line | 11601 56TH CT N
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City | CLEARWATER
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State | FL
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Zip | 33760-4805
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Country | US
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Telephone | 727-851-9880
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Fax | 866-727-2399
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Authorized Official
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Title or Position | CEO
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Name | MR. JEFF CLEVELAND
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Credential |
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Telephone | 727-851-9880
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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 | 1313895
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License Number State | FL
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