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General NPI Number Information
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NPI Number | 1619465689
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Entity Type | Organization
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Legal Business Name | ABACOA MEDICAL SUPPLIES INC
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Dates
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Enumeration Date | 04/25/2018
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Last Update Date | 05/15/2024
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Provider Practice Location Address
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Address Line | 3100 NW BOCA RATON BLVD STE 213
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City | BOCA RATON
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State | FL
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Zip | 33431-6658
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Country | US
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Telephone | 561-994-2302
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Fax | 888-204-4514
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Provider Business Mailing Address
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Address Line | 3100 NW BOCA RATON BLVD STE 213
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City | BOCA RATON
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State | FL
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Zip | 33431-6658
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Country | US
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Telephone | 561-994-2302
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Fax | 888-204-4514
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Authorized Official
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Title or Position | PRESIDENT
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Name | LAWRENCE A DICKSON
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Credential |
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Telephone | 561-994-2302
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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 |
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License Number State |
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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 | 2018106632
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License Number State | FL
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