Provider Demographics
NPI:1215551239
Name:DADE MEDICAL, INC.
Entity Type:Organization
Organization Name:DADE MEDICAL, INC.
Other - Org Name:INTEGRATED HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-215-4264
Mailing Address - Street 1:3700 COMMERCE PKWY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3912
Mailing Address - Country:US
Mailing Address - Phone:844-215-4264
Mailing Address - Fax:844-215-4265
Practice Address - Street 1:7703 ANDERSON RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-3039
Practice Address - Country:US
Practice Address - Phone:844-215-4264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DADE MEDICAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-05
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100109000Medicaid