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NPI Code Detail

MEDICARE: ANGELICA MEDICAL SUPPLY CORP

MEDICARE: ANGELICA MEDICAL SUPPLY CORP
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
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1275158685
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANGELICA MEDICAL SUPPLY CORP
Provider Business Mailing Address
First Line : 3534 W. FLAGLER ST.
Second Line : SUITE A
City : MIAMI
State : FL
Zip : 33135-1028
Country : US
Telephone Number : 786-536-2133
Fax Number : 786-536-2170
Provider Business Practice Location Address
First Line : 3534 W FLAGLER ST.
Second Line : SUITE A
City : MIAMI
State : FL
Zip : 33135-1028
Country : US
Telephone Number : 786-536-2133
Fax Number : 786-536-2170
Authorized Official
Title or Position : PRESIDENT
Name : RIGOBERTO ALONSO
Credential :
Telephone Number : 786-536-2133
Provider Enumeration Date : 06/11/2020
Last Update Date : 08/25/2021

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Directions to “ANGELICA MEDICAL SUPPLY CORP ” Practice Location

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