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NPI Code Detail

MEDICARE: MEDNOVA DME LLC

MEDICARE: MEDNOVA DME 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
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1285561357
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDNOVA DME LLC
Provider Business Mailing Address
First Line : 10700 MYSTIC CIR APT 106
Second Line :
City : ORLANDO
State : FL
Zip : 32836-6619
Country : US
Telephone Number : 201-820-6973
Fax Number :
Provider Business Practice Location Address
First Line : 10700 MYSTIC CIR APT 106
Second Line :
City : ORLANDO
State : FL
Zip : 32836-6619
Country : US
Telephone Number : 201-820-6973
Fax Number :
Authorized Official
Title or Position : OWNER
Name : GHULAM MUJTABA SHAREEF
Credential :
Telephone Number : 201-820-6973
Provider Enumeration Date : 05/05/2026
Last Update Date : 05/05/2026

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Directions to “MEDNOVA DME LLC ” Practice Location

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