1952346496 NPI number — MAIDELYN MEDICAL EQUIPMENT, CORP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952346496 NPI number — MAIDELYN MEDICAL EQUIPMENT, CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MAIDELYN MEDICAL EQUIPMENT, CORP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952346496
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6555 NW 36TH ST
Provider Second Line Business Mailing Address:
STE 206
Provider Business Mailing Address City Name:
VIRGINIA GARDENS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33166-6978
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-871-1800
Provider Business Mailing Address Fax Number:
305-871-6888

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6555 NW 36TH ST
Provider Second Line Business Practice Location Address:
STE 206
Provider Business Practice Location Address City Name:
VIRGINIA GARDENS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33166-6978
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-871-1800
Provider Business Practice Location Address Fax Number:
305-871-6888
Provider Enumeration Date:
06/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PEREZ
Authorized Official First Name:
SECUNDINO
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
305-871-1800

Provider Taxonomy Codes

  • Taxonomy code: 332BX2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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