MEDICARE: PREMIER MEDICAL EQUIPMENT PROVIDER 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	:	1568403939
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER MEDICAL EQUIPMENT PROVIDER INC

Provider Business Mailing Address
First Line	:	10471 SW 88TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-1508
Country	:	US
Telephone Number	:	305-279-7930
Fax Number	:	305-279-7931

Provider Business Practice Location Address
First Line	:	10471 SW 88TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-1508
Country	:	US
Telephone Number	:	305-279-7930
Fax Number	:	305-279-7931

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SERVIO T HERNANDEZ
Credential	:
Telephone Number	:	305-279-7930

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	08/22/2020

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