Provider Demographics
NPI:1164447207
Name:MMB MEDICAL EQUIPMENT INC.
Entity Type:Organization
Organization Name:MMB MEDICAL EQUIPMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARISELA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUITRAGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-827-3236
Mailing Address - Street 1:4160 W 16TH AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-5853
Mailing Address - Country:US
Mailing Address - Phone:305-827-3236
Mailing Address - Fax:305-827-3236
Practice Address - Street 1:4160 WEST 16 AVE SUITE 206
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012
Practice Address - Country:US
Practice Address - Phone:305-827-3236
Practice Address - Fax:305-827-3236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL59991073332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies