Provider Demographics
NPI:1225085756
Name:LONG LIFE MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:LONG LIFE MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ORISBEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPINOSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-888-7595
Mailing Address - Street 1:730 SE 8TH ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-5646
Mailing Address - Country:US
Mailing Address - Phone:305-888-7595
Mailing Address - Fax:305-888-7635
Practice Address - Street 1:730 SE 8TH ST
Practice Address - Street 2:SUITE 104
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-5646
Practice Address - Country:US
Practice Address - Phone:305-888-7595
Practice Address - Fax:305-888-7635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-29
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5127640001Medicare NSC