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General NPI Number Information
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NPI Number | 1609745264
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Entity Type | Organization
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Legal Business Name | S FL SUPREME SERVICES CORP
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Dates
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Enumeration Date | 11/03/2025
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 7500 NW 25TH ST STE 200B
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City | DORAL
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State | FL
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Zip | 33122-1721
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Country | US
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Telephone | 305-910-7566
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Fax |
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Provider Business Mailing Address
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Address Line | 9895 SW 58TH ST
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City | MIAMI
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State | FL
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Zip | 33173-1414
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Country | US
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Telephone | 305-910-7566
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ILIEVA VALDES
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Credential |
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Telephone | 305-910-7566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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