MEDICARE: NORTH FLORIDA OXYGEN AND MEDICAL 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)	1313210	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	326449	OTHER	FL	MEDICAL OXYGEN RETAILER
2	1313210	OTHER	FL	AHCA HME AND SERVICES

General Provider Information

NPI Number	:	1063567758
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH FLORIDA OXYGEN AND MEDICAL INC.

Provider Business Mailing Address
First Line	:	3380 SE LAKE WEIR ROAD
Second Line	:	STE B
City	:	OCALA
State	:	FL
Zip	:	34471-6725
Country	:	US
Telephone Number	:	352-401-0202
Fax Number	:

Provider Business Practice Location Address
First Line	:	3380 SE LAKE WEIR ROAD
Second Line	:	STE B.
City	:	OCALA
State	:	FL
Zip	:	34471-6725
Country	:	US
Telephone Number	:	352-401-0202
Fax Number	:

Authorized Official
Title or Position	:	SECRETARY TREASURER
Name	:	SID DUANE RUSSELL
Credential	:
Telephone Number	:	352-401-0202

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	02/04/2008

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