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General NPI Number Information
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NPI Number | 1912945940
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Entity Type | Organization
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Legal Business Name | TEBAR MEDICAL SUPPLIES & EQUIPMENT, INC.
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 11/11/2011
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Provider Practice Location Address
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Address Line | 14341 SW 120TH ST SUITE 102
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City | MIAMI
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State | FL
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Zip | 33186-7032
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Country | US
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Telephone | 305-382-0510
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Fax | 305-382-0520
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Provider Business Mailing Address
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Address Line | 14341 SW 120TH ST SUITE 102
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City | MIAMI
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State | FL
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Zip | 33186-7032
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Country | US
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Telephone | 305-382-0510
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Fax | 305-382-0520
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. THERESA BARROSO
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Credential |
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Telephone | 305-382-0510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | 332BP3500X
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | OXYGEN 32:03324
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | AHCA 2087
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License Number State | FL
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