Provider Demographics
NPI:1124029806
Name:ESMAR MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:ESMAR MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTA
Authorized Official - Middle Name:F
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-556-3661
Mailing Address - Street 1:4501 PALM AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4010
Mailing Address - Country:US
Mailing Address - Phone:305-556-3661
Mailing Address - Fax:305-556-3534
Practice Address - Street 1:4501 PALM AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4010
Practice Address - Country:US
Practice Address - Phone:305-556-3661
Practice Address - Fax:305-556-3534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1190332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0719880001Medicare ID - Type Unspecified