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General NPI Number Information
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NPI Number | 1669873469
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Entity Type | Organization
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Legal Business Name | LILY MEDICAL, LLC
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Dates
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Enumeration Date | 09/11/2014
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Last Update Date | 10/27/2014
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Provider Practice Location Address
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Address Line | 7680 UNIVERSAL BLVD STE 575
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City | ORLANDO
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State | FL
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Zip | 32819-8900
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Country | US
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Telephone | 573-893-7111
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Fax | 573-415-0413
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Provider Business Mailing Address
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Address Line | PO BOX 743122
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City | ATLANTA
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State | GA
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Zip | 30374-3122
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Country | US
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Telephone | 573-893-7111
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Fax | 573-415-0413
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Authorized Official
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Title or Position | OWNER
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Name | PATRICK TOMASSI
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Credential |
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Telephone | 537-893-7111
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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 | L14000135305
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License Number State | FL
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