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General NPI Number Information
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NPI Number | 1649336157
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Entity Type | Organization
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Legal Business Name | LIFELINE MEDICAL & RESPIRATORY EQUIPMENT PROVIDERS
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 09/18/2008
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Provider Practice Location Address
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Address Line | 1946 MEARS PKWY
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City | MARGATE
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State | FL
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Zip | 33063-3701
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Country | US
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Telephone | 954-917-1960
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Fax |
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Provider Business Mailing Address
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Address Line | 1946 MEARS PKWY
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City | MARGATE
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State | FL
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Zip | 33063-3701
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JANICE MONIZ- VASALLO
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Credential |
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Telephone | 954-917-1960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 1312730
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License Number State | FL
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