Provider Demographics
NPI:1033154331
Name:PALMETTO BAY MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:PALMETTO BAY MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARMANDO
Authorized Official - Middle Name:A
Authorized Official - Last Name:CESAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-556-1989
Mailing Address - Street 1:15715 S DIXIE HWY STE 217
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-1876
Mailing Address - Country:US
Mailing Address - Phone:786-430-0944
Mailing Address - Fax:786-430-1054
Practice Address - Street 1:15715 S DIXIE HWY STE 217
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-1876
Practice Address - Country:US
Practice Address - Phone:786-430-0944
Practice Address - Fax:786-430-1054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies