MEDICARE: ABC HOSPITAL EQUIPMENT & SUPPLY

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	:	1407903735
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABC HOSPITAL EQUIPMENT & SUPPLY

Provider Business Mailing Address
First Line	:	4721 SW 75TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-4436
Country	:	US
Telephone Number	:	305-665-7422
Fax Number	:	305-260-9748

Provider Business Practice Location Address
First Line	:	4721 SW 75TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-4436
Country	:	US
Telephone Number	:	305-665-7422
Fax Number	:	305-260-9748

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARIO CUERVO
Credential	:
Telephone Number	:	305-665-7422

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	08/22/2020

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