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General NPI Number Information
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NPI Number | 1962681221
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Entity Type | Organization
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Legal Business Name | KRYSTAL MEDICAL SERVICES
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Dates
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Enumeration Date | 11/02/2007
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Last Update Date | 02/29/2008
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Provider Practice Location Address
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Address Line | 7511 NW 73RD ST 104
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City | MIAMI
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State | FL
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Zip | 33166-2403
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Country | US
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Telephone | 305-889-0310
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Fax | 305-889-1168
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Provider Business Mailing Address
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Address Line | 7511 NW 73RD ST 104
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City | MIAMI
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State | FL
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Zip | 33166-2403
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Country | US
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Telephone | 305-889-0310
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Fax | 305-889-1168
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARIA L MENEDEZ
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Credential | OWNER
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Telephone | 305-773-1355
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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 | 0888450002
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License Number State | FL
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