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General NPI Number Information
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NPI Number | 1477589968
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Entity Type | Organization
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Legal Business Name | CORPUS CHRISTI MEDICAL SUPPLIES INC
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Dates
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Enumeration Date | 06/25/2006
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Last Update Date | 02/15/2008
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Provider Practice Location Address
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Address Line | 215 SW 17TH AVE SUITE 310
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City | MIAMI
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State | FL
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Zip | 33135-3689
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Country | US
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Telephone | 305-649-8271
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Fax | 305-649-6988
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Provider Business Mailing Address
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Address Line | 215 SW 17TH AVE SUITE 310
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City | MIAMI
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State | FL
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Zip | 33135-3689
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Country | US
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Telephone | 305-649-8271
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Fax | 305-649-6988
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARINA NIEVES
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Credential |
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Telephone | 305-649-8271
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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 | 3203663
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 1312083
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License Number State | FL
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