=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538040035
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AVB MEDICAL SUPPLY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/10/2025
-----------------------------------------------------
Last Update Date | 09/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 773 S KIRKMAN RD STE 101G
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32811-2046
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-270-5544
-----------------------------------------------------
Fax | 689-698-2565
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 773 S KIRKMAN RD STE 101G
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32811-2046
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-270-5544
-----------------------------------------------------
Fax | 689-698-2565
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | TRUSTEE
-----------------------------------------------------
Name | AVIS LORRAINE BROWN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 407-270-5544
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------