Provider Demographics
NPI:1174284434
Name:MAS OSTOMY CARE, LLC
Entity Type:Organization
Organization Name:MAS OSTOMY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MAKY
Authorized Official - Middle Name:ANTUANET
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, NP-C, WOCN
Authorized Official - Phone:786-575-2010
Mailing Address - Street 1:13727 SW 152ND ST # 1107
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-1106
Mailing Address - Country:US
Mailing Address - Phone:786-575-2010
Mailing Address - Fax:
Practice Address - Street 1:13727 SW 152ND ST # 1107
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-1106
Practice Address - Country:US
Practice Address - Phone:786-575-2010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-07
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care