MEDICARE: SWFL MEDICAL SUPPLIES

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	:	1407202062
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SWFL MEDICAL SUPPLIES

Provider Business Mailing Address
First Line	:	12995 S CLEVELAND AVE
Second Line	:	SUITE 209
City	:	FORT MYERS
State	:	FL
Zip	:	33907-3890
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12995 S CLEVELAND AVE
Second Line	:	SUITE 209
City	:	FORT MYERS
State	:	FL
Zip	:	33907-3890
Country	:	US
Telephone Number	:	239-440-1344
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MALEK M KHALIL
Credential	:
Telephone Number	:	239-440-1344

Provider Enumeration Date	:	05/12/2016
Last Update Date	:	05/12/2016

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