MEDICARE: MIAMI SUNSHINE MEDICAL SUPPLY CORP

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	332BX2000X	Oxygen Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1639134737
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIAMI SUNSHINE MEDICAL SUPPLY CORP

Provider Business Mailing Address
First Line	:	1881 W FLAGLER ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135-1939
Country	:	US
Telephone Number	:	305-642-8505
Fax Number	:	305-642-8505

Provider Business Practice Location Address
First Line	:	1881 W FLAGLER ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135-1939
Country	:	US
Telephone Number	:	305-642-8505
Fax Number	:	305-642-8505

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JAVIER DE LA CRUZ
Credential	:
Telephone Number	:	305-642-8505

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	08/22/2020

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Directions to “MIAMI SUNSHINE MEDICAL SUPPLY CORP ” Practice Location

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