MEDICARE: EXPRESS MEDICAL SUPLIES AND 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

General Provider Information

NPI Number	:	1881762615
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXPRESS MEDICAL SUPLIES AND SERVICES CORP

Provider Business Mailing Address
First Line	:	3460 W 84TH ST
Second Line	:	STE 103
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33018-4926
Country	:	US
Telephone Number	:	305-792-2540
Fax Number	:

Provider Business Practice Location Address
First Line	:	3460 W 84TH ST
Second Line	:	STE 103
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33018-4926
Country	:	US
Telephone Number	:	305-792-2540
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SERGIO GONZALEZ
Credential	:
Telephone Number	:	305-792-2540

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	08/22/2020

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