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General NPI Number Information
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NPI Number | 1700085040
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Entity Type | Organization
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Legal Business Name | ICON MEDICAL EQUIPMENT LLC
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Dates
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Enumeration Date | 07/17/2007
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 1271 NE 140TH ST
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City | NORTH MIAMI
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State | FL
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Zip | 33161-3432
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Country | US
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Telephone | 305-644-8879
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Fax | 305-644-8893
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Provider Business Mailing Address
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Address Line | 1271 NE 140TH ST
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City | NORTH MIAMI
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State | FL
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Zip | 33161-4140
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Country | US
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Telephone | 305-644-8879
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Fax | 305-644-8893
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Authorized Official
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Title or Position | PRESIDENT
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Name | HECTOR BELLO
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Credential |
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Telephone | 305-644-8879
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PH23433
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License Number State | FL
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