MEDICARE: FLORIDA USA SUPPLIES 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	:	1902455959
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA USA SUPPLIES INC

Provider Business Mailing Address
First Line	:	17325 NW 27TH AVE STE 209
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33056-4012
Country	:	US
Telephone Number	:	305-474-3030
Fax Number	:	305-474-3006

Provider Business Practice Location Address
First Line	:	17325 NW 27TH AVE STE 209
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33056-4012
Country	:	US
Telephone Number	:	305-474-3030
Fax Number	:	305-474-3006

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MIGUEL ALBERTO CASTELLANO BLANCO
Credential	:
Telephone Number	:	305-474-3030

Provider Enumeration Date	:	09/11/2019
Last Update Date	:	09/11/2019

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