MEDICARE: EL SOL UNIVERSAL, 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)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1313553	OTHER	FL	AHCA
2	32:01589	OTHER	FL	MEDICAL OXYGEN PERMIT

General Provider Information

NPI Number	:	1245239086
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EL SOL UNIVERSAL, INC

Provider Business Mailing Address
First Line	:	7400 NW 77TH TERRACE
Second Line	:
City	:	MEDLEY
State	:	FL
Zip	:	33016-2213
Country	:	US
Telephone Number	:	305-882-0202
Fax Number	:	305-882-0205

Provider Business Practice Location Address
First Line	:	7400 NW 77TH TER
Second Line	:
City	:	MEDLEY
State	:	FL
Zip	:	33166-7503
Country	:	US
Telephone Number	:	305-882-0202
Fax Number	:	305-882-0205

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	MR. PAULINO HERNANDEZ
Credential	:
Telephone Number	:	305-882-0202

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	12/26/2013

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Directions to “EL SOL UNIVERSAL, INC ” Practice Location

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