MEDICARE: MEDICAL SYSTEMS OF CENTRAL FLORIDA

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	1108	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1072730001	OTHER	FL	MEDICARE

General Provider Information

NPI Number	:	1215000922
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL SYSTEMS OF CENTRAL FLORIDA

Provider Business Mailing Address
First Line	:	2416 LAKELAND HILLS BLVD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33805-2214
Country	:	US
Telephone Number	:	863-683-1170
Fax Number	:	863-680-1870

Provider Business Practice Location Address
First Line	:	2416 LAKELAND HILLS BLVD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33805-2214
Country	:	US
Telephone Number	:	863-683-1170
Fax Number	:	863-680-1870

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. NANCY ANN EDWARDS
Credential	:
Telephone Number	:	863-683-1170

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	04/14/2008

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