Provider Demographics
NPI:1033237128
Name:MEDIQUIP & SUPPLIES, INC.
Entity Type:Organization
Organization Name:MEDIQUIP & SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YAILED
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-234-7732
Mailing Address - Street 1:12011 SW 129TH CT
Mailing Address - Street 2:UNIT 5
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6930
Mailing Address - Country:US
Mailing Address - Phone:305-234-7732
Mailing Address - Fax:305-234-7729
Practice Address - Street 1:12011 SW 129TH CT
Practice Address - Street 2:UNIT 5
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6930
Practice Address - Country:US
Practice Address - Phone:305-234-7732
Practice Address - Fax:305-234-7729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPENDINGMedicare ID - Type UnspecifiedMEDICARE PROVIDER
FL6065270001Medicare NSC