Provider Demographics
NPI:1083215511
Name:SUPPLIES PLUS FL INC
Entity Type:Organization
Organization Name:SUPPLIES PLUS FL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SUPER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:917-449-7582
Mailing Address - Street 1:223 ISLAND WAY APT 5F
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33767-2254
Mailing Address - Country:US
Mailing Address - Phone:917-449-7582
Mailing Address - Fax:
Practice Address - Street 1:223 ISLAND WAY APT 5F
Practice Address - Street 2:
Practice Address - City:CLEARWATER BEACH
Practice Address - State:FL
Practice Address - Zip Code:33767-2254
Practice Address - Country:US
Practice Address - Phone:917-449-7582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies