MEDICARE: DEL RISCO MEDICAL SERVICES 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	332B00000X	Durable Medical Equipment & Medical Supplies	1312819AHCA	FL

General Provider Information

NPI Number	:	1851365118
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEL RISCO MEDICAL SERVICES CORP

Provider Business Mailing Address
First Line	:	9807 NW 80TH AVE
Second Line	:	BAY NO 11C
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33016
Country	:	US
Telephone Number	:	305-823-7500
Fax Number	:	305-823-0157

Provider Business Practice Location Address
First Line	:	9807 NW 80TH AVE
Second Line	:	BAY NO 11C
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33016
Country	:	US
Telephone Number	:	305-823-7500
Fax Number	:	305-823-0157

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MARIO A DELRISCO
Credential	:
Telephone Number	:	305-823-7500

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	08/22/2020

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