Provider Demographics
NPI:1114945995
Name:FIRST STOP MEDICAL SUPPLIES CORP
Entity Type:Organization
Organization Name:FIRST STOP MEDICAL SUPPLIES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:OMAR
Authorized Official - Last Name:NAVARRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-587-9913
Mailing Address - Street 1:4165 NW 132 ST
Mailing Address - Street 2:BAY #10
Mailing Address - City:OPA LOCKA
Mailing Address - State:FL
Mailing Address - Zip Code:33054
Mailing Address - Country:US
Mailing Address - Phone:305-769-9332
Mailing Address - Fax:305-769-2676
Practice Address - Street 1:4165 NW 132 ST
Practice Address - Street 2:BAY #10
Practice Address - City:OPA LOCKA
Practice Address - State:FL
Practice Address - Zip Code:33054
Practice Address - Country:US
Practice Address - Phone:305-769-9332
Practice Address - Fax:305-769-2676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAHCA1312813332B00000X
332BP3500X
FL3204448332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5614280001Medicare NSC