Provider Demographics
NPI:1053071738
Name:PICADO MEDICAL SUPPLY INC.
Entity Type:Organization
Organization Name:PICADO MEDICAL SUPPLY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PICADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-297-5588
Mailing Address - Street 1:2450 SW 137TH AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6312
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2450 SW 137TH AVE STE 206
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6312
Practice Address - Country:US
Practice Address - Phone:305-297-5588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-22
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies