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General NPI Number Information
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NPI Number | 1942355284
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Entity Type | Organization
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Legal Business Name | TRISTA SERVICE, INC
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 15160 SW 136 ST S-10
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City | MIAMI
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State | FL
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Zip | 33196-6795
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Country | US
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Telephone | 305-259-0091
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Fax | 305-259-0092
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Provider Business Mailing Address
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Address Line | 15160 SW 136 ST S-10 S-10
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City | MIAMI
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State | FL
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Zip | 33196-6795
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Country | US
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Telephone | 305-259-0091
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Fax | 305-259-0092
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROBERTO SANCHEZ
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Credential |
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Telephone | 305-259-0091
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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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