MEDICARE: CORAL MED SUPPLY 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	:	1801276100
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORAL MED SUPPLY INC

Provider Business Mailing Address
First Line	:	3446 SW 8TH ST
Second Line	:	SUITE 209
City	:	MIAMI
State	:	FL
Zip	:	33135-4145
Country	:	US
Telephone Number	:	305-438-6145
Fax Number	:	305-602-8919

Provider Business Practice Location Address
First Line	:	3446 SW 8TH ST
Second Line	:	SUITE 209
City	:	MIAMI
State	:	FL
Zip	:	33135-4145
Country	:	US
Telephone Number	:	305-438-6145
Fax Number	:	305-602-8919

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROBERTO NODARCE MOREJON
Credential	:
Telephone Number	:	305-438-6145

Provider Enumeration Date	:	06/02/2015
Last Update Date	:	11/05/2015

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Directions to “CORAL MED SUPPLY INC ” Practice Location

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