Provider Demographics
NPI:1043249154
Name:SERVE MEDICAL SUPPLIES, INC
Entity Type:Organization
Organization Name:SERVE MEDICAL SUPPLIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SERVANDO
Authorized Official - Middle Name:JESUS
Authorized Official - Last Name:ACOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-644-3575
Mailing Address - Street 1:1090 SW 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-4634
Mailing Address - Country:US
Mailing Address - Phone:305-644-3575
Mailing Address - Fax:305-644-3566
Practice Address - Street 1:1090 SW 27TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-4634
Practice Address - Country:US
Practice Address - Phone:305-644-3575
Practice Address - Fax:305-644-3566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5762080001Medicare NSC