Provider Demographics
NPI:1225068026
Name:DOLPHIN SUPPLIES MEDICAL INC
Entity Type:Organization
Organization Name:DOLPHIN SUPPLIES MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:NORKA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUSHIKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-854-2124
Mailing Address - Street 1:1101 SW 8 ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130
Mailing Address - Country:US
Mailing Address - Phone:305-854-2124
Mailing Address - Fax:305-854-2125
Practice Address - Street 1:1101 SW 8 ST
Practice Address - Street 2:SUITE 204
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130
Practice Address - Country:US
Practice Address - Phone:305-854-2124
Practice Address - Fax:305-854-2125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1312463332B00000X
FL3204093332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5357130001Medicare NSC