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General NPI Number Information
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NPI Number | 1841806684
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Entity Type | Organization
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Legal Business Name | MEDLY LLC
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Dates
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Enumeration Date | 09/17/2020
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Last Update Date | 09/17/2020
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Provider Practice Location Address
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Address Line | 1305 MORGAN STANLEY AVE UNIT 335
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City | WINTER PARK
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State | FL
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Zip | 32789-1961
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Country | US
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Telephone | 407-476-4260
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Fax | 855-746-1576
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Provider Business Mailing Address
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Address Line | 1305 MORGAN STANLEY AVE UNIT 335
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City | WINTER PARK
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State | FL
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Zip | 32789-1961
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Country | US
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Telephone | 407-476-4260
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Fax | 855-746-1576
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Authorized Official
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Title or Position | CEO
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Name | BRENNDA KAIA REIS
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Credential |
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Telephone | 954-304-0379
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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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