MEDICARE: GRACE SUPPLIES LLC

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	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1225985724
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACE SUPPLIES LLC

Provider Business Mailing Address
First Line	:	20451 NW 2ND AVE STE 106
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-2539
Country	:	US
Telephone Number	:	954-495-7427
Fax Number	:

Provider Business Practice Location Address
First Line	:	20451 NW 2ND AVE STE 106
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-2539
Country	:	US
Telephone Number	:	954-495-7427
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MISS RACHEL GRACE WONG
Credential	:
Telephone Number	:	954-495-7427

Provider Enumeration Date	:	03/13/2026
Last Update Date	:	03/13/2026

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Directions to “GRACE SUPPLIES LLC ” Practice Location

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