MEDICARE: SERVE MEDICAL SUPPLIES, INC

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
1	332BX2000X	Oxygen Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1043249154
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERVE MEDICAL SUPPLIES, INC

Provider Business Mailing Address
First Line	:	1090 SW 27TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135-4634
Country	:	US
Telephone Number	:	305-644-3575
Fax Number	:	305-644-3566

Provider Business Practice Location Address
First Line	:	1090 SW 27TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135-4634
Country	:	US
Telephone Number	:	305-644-3575
Fax Number	:	305-644-3566

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. SERVANDO JESUS ACOSTA
Credential	:
Telephone Number	:	305-644-3575

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	12/11/2007

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