Provider Demographics
NPI:1164652558
Name:LIBERATOR MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:LIBERATOR MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIO
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAUJO FILHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-678-9964
Mailing Address - Street 1:1823 SE AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-4012
Mailing Address - Country:US
Mailing Address - Phone:800-323-0914
Mailing Address - Fax:877-730-7796
Practice Address - Street 1:1823 SE AIRPORT RD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996-4012
Practice Address - Country:US
Practice Address - Phone:800-323-0914
Practice Address - Fax:877-730-7796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-20
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies