MEDICARE: MEDENVIOS HEALTHCARE, 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	332B00000X	Durable Medical Equipment & Medical Supplies	1312693	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376648501
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDENVIOS HEALTHCARE, INC.

Provider Business Mailing Address
First Line	:	7415 CORPORATE CENTER DR STE E
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-1215
Country	:	US
Telephone Number	:	305-639-1980
Fax Number	:	305-639-1979

Provider Business Practice Location Address
First Line	:	7415 CORPORATE CENTER DR STE E
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-1215
Country	:	US
Telephone Number	:	305-639-1980
Fax Number	:	305-639-1979

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MICHAEL PAUL GARCIA
Credential	:
Telephone Number	:	305-639-1980

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	08/20/2020

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