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General NPI Number Information
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NPI Number | 1841546553
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Entity Type | Organization
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Legal Business Name | COSTAL DURABLE MEDICAL SUPPLIES INC
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Dates
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Enumeration Date | 07/31/2012
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Last Update Date | 07/31/2012
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Provider Practice Location Address
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Address Line | 3812 TOWNSHIP SQUARE BLVD APT 412
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City | ORLANDO
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State | FL
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Zip | 32837-5380
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Country | US
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Telephone | 407-600-6199
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Fax |
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Provider Business Mailing Address
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Address Line | 3812 TOWNSHIP SQUARE BLVD APT 412
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City | ORLANDO
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State | FL
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Zip | 32837-5380
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Country | US
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Telephone | 407-600-6199
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | FLOR MENDOZA
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Credential |
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Telephone | 407-600-6199
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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 | FL
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