MEDICARE: SUPREME SERVICE MEDICAL EQUIPMENT 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1073532941
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUPREME SERVICE MEDICAL EQUIPMENT INC

Provider Business Mailing Address
First Line	:	7446 NW 8TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-2913
Country	:	US
Telephone Number	:	786-388-0409
Fax Number	:	786-388-0408

Provider Business Practice Location Address
First Line	:	7446 NW 8TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-2913
Country	:	US
Telephone Number	:	786-388-0409
Fax Number	:	786-388-0408

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. YURI PEREZ
Credential	:
Telephone Number	:	786-388-0409

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	08/22/2020

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