MEDICARE: TRADELINE SH 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

General Provider Information

NPI Number	:	1477207447
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRADELINE SH INC

Provider Business Mailing Address
First Line	:	7543 W WATERS AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-1511
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7543 W WATERS AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-1511
Country	:	US
Telephone Number	:	813-886-2800
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RAAFAT MOSSAD HABIB
Credential	:
Telephone Number	:	813-886-2800

Provider Enumeration Date	:	02/09/2022
Last Update Date	:	02/09/2022

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