Provider Demographics
NPI:1134500671
Name:DIAPER DEPOT USA LLC
Entity Type:Organization
Organization Name:DIAPER DEPOT USA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPIDALIERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-308-3570
Mailing Address - Street 1:932 N DIXIE HWY
Mailing Address - Street 2:UNIT 2
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-2573
Mailing Address - Country:US
Mailing Address - Phone:561-308-3570
Mailing Address - Fax:
Practice Address - Street 1:932 N DIXIE HWY
Practice Address - Street 2:UNIT 2
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33460-2573
Practice Address - Country:US
Practice Address - Phone:561-308-3570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-10
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15-0036129332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013391800Medicaid