Provider Demographics
NPI:1225014467
Name:WESTLAND MEDICAL EQUIPMENT CORP
Entity Type:Organization
Organization Name:WESTLAND MEDICAL EQUIPMENT CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:L
Authorized Official - Last Name:PORTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-821-8880
Mailing Address - Street 1:1800 W 49TH ST
Mailing Address - Street 2:SUITE 324H
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2900
Mailing Address - Country:US
Mailing Address - Phone:305-821-8880
Mailing Address - Fax:305-821-8841
Practice Address - Street 1:1800 W 49TH ST
Practice Address - Street 2:SUITE 324H
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2900
Practice Address - Country:US
Practice Address - Phone:305-821-8880
Practice Address - Fax:305-821-8841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-20
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2206332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4878080001Medicare NSC