=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598753527
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SUNBELT MEDICAL SUPPLY & OXYGEN, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/13/2005
-----------------------------------------------------
Last Update Date | 10/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3325 BARTLETT BLVD
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32811-6428
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-563-6580
-----------------------------------------------------
Fax | 407-264-6488
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 555 E NORTH LN STE 5075
-----------------------------------------------------
City | CONSHOHOCKEN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19428-2490
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CCO
-----------------------------------------------------
Name | WENDY RUSSALESI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 484-246-9499
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332BP3500X
-----------------------------------------------------
Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
-----------------------------------------------------
License Number | PH19355
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 332BX2000X
-----------------------------------------------------
Taxonomy Name | Oxygen Equipment & Supplies (DME)
-----------------------------------------------------
License Number | 32 6743
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------