MEDICARE: GOLD STAR MEDICAL SERVICES 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	:	1164447967
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLD STAR MEDICAL SERVICES INC

Provider Business Mailing Address
First Line	:	951 NE 167TH ST
Second Line	:	STE 134
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-3711
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	951 NE 167TH ST
Second Line	:	STE 134
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-3711
Country	:	US
Telephone Number	:	305-792-2540
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	OMAR LOPEZ ALVAREZ
Credential	:
Telephone Number	:	305-792-2540

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	08/22/2020

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