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General NPI Number Information
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NPI Number | 1922044064
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Entity Type | Organization
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Legal Business Name | EXCEL DIABETIC SERVICES LLC
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 01/11/2012
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Provider Practice Location Address
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Address Line | 1035 NE 125TH ST SUITE 200
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City | NORTH MIAMI
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State | FL
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Zip | 33161-5820
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Country | US
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Telephone | 305-891-9992
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Fax | 888-999-4890
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Provider Business Mailing Address
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Address Line | 1035 NE 125TH ST SUITE 200
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City | NORTH MIAMI
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State | FL
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Zip | 33161-5820
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Country | US
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Telephone | 305-891-9992
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Fax | 888-999-4890
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Authorized Official
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Title or Position | MANAGING EMPLOYEE
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Name | MICHAEL KOCHEN
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Credential |
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Telephone | 305-891-9992
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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 | 0D-020
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License Number State | FL
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