=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760360762
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMADO BOCALANDRO
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/26/2025
-----------------------------------------------------
Last Update Date | 08/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 42850 SCHOENHERR RD STE 6
-----------------------------------------------------
City | STERLING HEIGHTS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48313-2875
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-255-0705
-----------------------------------------------------
Fax | 248-769-6400
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 21366 HALL RD # 4053
-----------------------------------------------------
City | CLINTON TWP
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48038-1539
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-255-0705
-----------------------------------------------------
Fax | 248-769-6400
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------