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NPI Code Detail

MEDICARE: CABULOG

MEDICARE: CABULOG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1003686924
Entity Type Code : Organization
Provider Name (Legal Business Name) : CABULOG
Provider Business Mailing Address
First Line : 3440 HOLLYWOOD BLVD STE 415
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33021-6933
Country : US
Telephone Number : 615-829-6712
Fax Number :
Provider Business Practice Location Address
First Line : 3440 HOLLYWOOD BLVD STE 415
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33021-6933
Country : US
Telephone Number : 615-829-6712
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MR. JACKY PIERRE
Credential :
Telephone Number : 615-829-6712
Provider Enumeration Date : 01/02/2024
Last Update Date : 01/02/2024

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Directions to “CABULOG ” Practice Location

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