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General NPI Number Information
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NPI Number | 1578942926
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Entity Type | Organization
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Legal Business Name | AXZELANT LLC
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Dates
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Enumeration Date | 05/19/2015
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Last Update Date | 05/19/2015
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Provider Practice Location Address
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Address Line | 11525 CORTEZ BLVD
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City | SPRING HILL
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State | FL
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Zip | 34613-7373
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Country | US
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Telephone | 813-479-7659
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Fax | 813-569-2220
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Provider Business Mailing Address
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Address Line | 11525 CORTEZ BLVD
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City | SPRING HILL
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State | FL
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Zip | 34613-7373
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Country | US
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Telephone | 813-479-7659
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Fax | 813-569-2220
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARIA D DOHERTY
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Credential |
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Telephone | 813-479-7659
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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 | CC1971409501
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License Number State | FL
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