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General NPI Number Information
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NPI Number | 1770521338
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Entity Type | Organization
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Legal Business Name | STAYWELL DIABETIC SUPPLIES
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1325 NW 93RD CT SUITE NUMBER B-103
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City | DORAL
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State | FL
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Zip | 33172-2857
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Country | US
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Telephone | 305-436-8945
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Fax | 305-436-8946
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Provider Business Mailing Address
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Address Line | 1325 NW 93RD CT SUITE NUMBER B-103
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City | DORAL
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State | FL
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Zip | 33172-2857
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Country | US
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Telephone | 305-436-8945
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Fax | 305-436-8946
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. SONIA M CANTELI
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Credential |
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Telephone | 786-222-3549
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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 | 603400-3
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License Number State | FL
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