1679689046 NPI number — DOCTORS MEDICAL RENTALS, CORP.

Table of content: (NPI 1679689046)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679689046 NPI number — DOCTORS MEDICAL RENTALS, CORP.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DOCTORS MEDICAL RENTALS, 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:
6
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:
1679689046
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/14/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10418 NW 31ST TERRACE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DORAL
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33172-1200
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-666-9911
Provider Business Mailing Address Fax Number:
305-666-1601

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10418 NW 31ST TERRACE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DORAL
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33172-1200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-666-9911
Provider Business Practice Location Address Fax Number:
305-666-1601
Provider Enumeration Date:
08/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PARDO
Authorized Official First Name:
ANGEL
Authorized Official Middle Name:
NELLO
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
305-666-9911

Provider Taxonomy Codes

  • Taxonomy code: 332BC3200X , with the licence number:  HME508 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 028697400 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 672169996 . This is a "WAIVER, MEDICAID" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 672169998 WAIVER , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: R4276 . This is a "BC&BS PROVIDER NO" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 672169979 WAIVER , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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