MEDICARE: DIRECT MEDICAL SUPPLIES

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	:	1205447034
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIRECT MEDICAL SUPPLIES

Provider Business Mailing Address
First Line	:	325 NW 130TH ST
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33168-3707
Country	:	US
Telephone Number	:	305-993-9474
Fax Number	:

Provider Business Practice Location Address
First Line	:	325 NW 130TH ST
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33168-3707
Country	:	US
Telephone Number	:	305-993-9474
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. MARIE LOIUES DEZINE
Credential	:
Telephone Number	:	305-993-9474

Provider Enumeration Date	:	08/14/2020
Last Update Date	:	04/16/2021

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Directions to “DIRECT MEDICAL SUPPLIES ” Practice Location

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