Provider Demographics
NPI:1225265739
Name:FLORIDA DME, LLC
Entity Type:Organization
Organization Name:FLORIDA DME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:JEROME
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-684-0710
Mailing Address - Street 1:4676 OKEECHOBEE BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417-4624
Mailing Address - Country:US
Mailing Address - Phone:561-684-0710
Mailing Address - Fax:561-689-7571
Practice Address - Street 1:4676 OKEECHOBEE BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-4624
Practice Address - Country:US
Practice Address - Phone:561-684-0710
Practice Address - Fax:561-689-7571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0003028332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies