Provider Demographics
NPI:1013590371
Name:MED MEDICAL SUPPLIES CORP
Entity Type:Organization
Organization Name:MED MEDICAL SUPPLIES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-901-7896
Mailing Address - Street 1:2500 NW 79TH AVE STE 223
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33122-1085
Mailing Address - Country:US
Mailing Address - Phone:954-709-7959
Mailing Address - Fax:
Practice Address - Street 1:2500 NW 79TH AVE STE 223
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33122-1085
Practice Address - Country:US
Practice Address - Phone:954-709-7959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-04
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies