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NPI Code Detail

MEDICARE: SOUTH FLORIDA MEDICAL STORE INC

MEDICARE: SOUTH FLORIDA MEDICAL STORE 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
1332BC3200XCustomized Equipment (DME)
2332BD1200XDialysis Equipment & Supplies (DME)
3332BN1400XNursing Facility Supplies (DME)
4332BP3500XParenteral & Enteral Nutrition Supplies (DME)
5332BX2000XOxygen Equipment & Supplies (DME)
6332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1710279013
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTH FLORIDA MEDICAL STORE INC
Provider Business Mailing Address
First Line : 4201 WESTGATE AVE
Second Line : SUITE B-14
City : WEST PALM BEACH
State : FL
Zip : 33409-4719
Country : US
Telephone Number : 561-855-7377
Fax Number : 561-855-7378
Provider Business Practice Location Address
First Line : 4201 WESTGATE AVE
Second Line : B-14
City : WEST PALM BEACH
State : FL
Zip : 33409-4719
Country : US
Telephone Number : 561-855-7377
Fax Number : 561-855-7378
Authorized Official
Title or Position : PRESIDENT
Name : MR. TIMOTHY V LEWIS
Credential :
Telephone Number : 561-855-7377
Provider Enumeration Date : 05/05/2011
Last Update Date : 04/24/2012

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Directions to “SOUTH FLORIDA MEDICAL STORE INC ” Practice Location

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