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General NPI Number Information
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NPI Number | 1821897471
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Entity Type | Organization
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Legal Business Name | MIRACLES MEDICAL SUPPLIES LLC
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 4674 TOWN CENTER PKWY APT 260
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City | JACKSONVILLE
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State | FL
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Zip | 32246-8904
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Country | US
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Telephone | 904-574-7180
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Fax | 904-574-7180
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Provider Business Mailing Address
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Address Line | 4674 TOWN CENTER PKWY APT 260
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City | JACKSONVILLE
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State | FL
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Zip | 32246-8904
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Country | US
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Telephone | 904-574-7180
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Fax |
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Authorized Official
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Title or Position | EMPLOYEE OF THE ORGANIZATION
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Name | LATASHA LOOPER
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Credential |
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Telephone | 904-574-7180
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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 |
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License Number State |
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