MEDICARE: MACAW HEALTH, 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	:	1912472671
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MACAW HEALTH, INC.

Provider Business Mailing Address
First Line	:	18350 NW 2ND AVE STE 406E
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-4519
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18350 NW 2ND AVE STE 406E
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-4519
Country	:	US
Telephone Number	:	727-743-8128
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MICHELLE KOEHLINGER
Credential	:
Telephone Number	:	727-743-8128

Provider Enumeration Date	:	10/09/2018
Last Update Date	:	10/09/2018

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Directions to “MACAW HEALTH, INC. ” Practice Location

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