MEDICARE: CENTRAL FLORIDA NEB DOCTORS, 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	1312535	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1312535	OTHER	FL	STATE DURABLE MEDICAL EQM

General Provider Information

NPI Number	:	1558432815
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL FLORIDA NEB DOCTORS, LLC

Provider Business Mailing Address
First Line	:	PO BOX 60609
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32906-0609
Country	:	US
Telephone Number	:	321-727-1836
Fax Number	:

Provider Business Practice Location Address
First Line	:	4640 LIPSCOMB ST NE
Second Line	:	SUITE #8
City	:	PALM BAY
State	:	FL
Zip	:	32905-2986
Country	:	US
Telephone Number	:	321-723-4775
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MARTIN F. DUPREY
Credential	:
Telephone Number	:	321-723-4775

Provider Enumeration Date	:	11/10/2006
Last Update Date	:	08/22/2020

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