MEDICARE: B&K MEDICAL 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1396587572
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	B&K MEDICAL SUPPLIES LLC

Provider Business Mailing Address
First Line	:	145 NW CENTRAL PARK PLZ STE 102
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34986-2482
Country	:	US
Telephone Number	:	888-350-7567
Fax Number	:

Provider Business Practice Location Address
First Line	:	145 NW CENTRAL PARK PLZ STE 102
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34986-2482
Country	:	US
Telephone Number	:	888-350-7567
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	IRFAN MUKATI
Credential	:
Telephone Number	:	888-350-7567

Provider Enumeration Date	:	06/10/2024
Last Update Date	:	06/03/2025

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Directions to “B&K MEDICAL SUPPLIES LLC ” Practice Location

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