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General NPI Number Information
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NPI Number | 1992876635
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Entity Type | Organization
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Legal Business Name | SPECIALTY VEHICLES SOUTHEAST, INC
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 685 BROAD ST
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City | PENSACOLA
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State | FL
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Zip | 32534-4202
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Country | US
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Telephone | 850-477-7645
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Fax | 850-478-6891
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Provider Business Mailing Address
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Address Line | 685 BROAD ST
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City | PENSACOLA
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State | FL
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Zip | 32534-4202
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Country | US
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Telephone | 850-477-7645
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN S BRISCIONE JR.
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Credential |
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Telephone | 850-477-7645
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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 | 162193
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License Number State | FL
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