MEDICARE: SEMINOLE MEDICAL SUPPLY, 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)	3201689	FL

General Provider Information

NPI Number	:	1164443016
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEMINOLE MEDICAL SUPPLY, INC.

Provider Business Mailing Address
First Line	:	285 W CENTRAL PKWY
Second Line	:	#1704
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32714-2579
Country	:	US
Telephone Number	:	407-788-2263
Fax Number	:	407-788-3919

Provider Business Practice Location Address
First Line	:	285 W CENTRAL PKWY
Second Line	:	#1704
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32714-2579
Country	:	US
Telephone Number	:	407-788-2263
Fax Number	:	407-788-3919

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. DANIEL R SIMRING
Credential	:
Telephone Number	:	407-788-2263

Provider Enumeration Date	:	07/23/2006
Last Update Date	:	08/22/2020

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