MEDICARE: SUPERIOR MEDICAL 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	3336C0003X	Community/Retail Pharmacy	PH22060	FL

General Provider Information

NPI Number	:	1417026709
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUPERIOR MEDICAL SUPPLY

Provider Business Mailing Address
First Line	:	7264 SW 8TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-4654
Country	:	US
Telephone Number	:	786-312-4868
Fax Number	:	305-262-5644

Provider Business Practice Location Address
First Line	:	7264 SW 8TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-4654
Country	:	US
Telephone Number	:	786-312-4868
Fax Number	:	305-262-5644

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MEDYN M GESSA
Credential	:
Telephone Number	:	786-312-4868

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	08/22/2020

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Directions to “SUPERIOR MEDICAL SUPPLY ” Practice Location

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