Provider Demographics
NPI:1093419426
Name:HIBERIS CORP
Entity Type:Organization
Organization Name:HIBERIS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSILENE
Authorized Official - Middle Name:CUSTODIO
Authorized Official - Last Name:GONCALVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-509-0427
Mailing Address - Street 1:3750 W COLONIAL DR # 2
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808-7906
Mailing Address - Country:US
Mailing Address - Phone:833-444-2374
Mailing Address - Fax:
Practice Address - Street 1:3750 W COLONIAL DR # 2
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-7906
Practice Address - Country:US
Practice Address - Phone:833-444-2374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment