Provider Demographics
NPI:1164744439
Name:MEDI-ONE SOUTH INC
Entity Type:Organization
Organization Name:MEDI-ONE SOUTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MR
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUMEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-648-0909
Mailing Address - Street 1:261 NE 1ST ST
Mailing Address - Street 2:SUITE 515
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132-2515
Mailing Address - Country:US
Mailing Address - Phone:646-648-0909
Mailing Address - Fax:305-274-0692
Practice Address - Street 1:261 NE 1ST ST
Practice Address - Street 2:SUITE 515
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33132-2515
Practice Address - Country:US
Practice Address - Phone:646-648-0909
Practice Address - Fax:305-274-0692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty