Provider Demographics
NPI:1225267263
Name:FULL SPECTRUM MEDICAL SOLUTIONS LLC
Entity Type:Organization
Organization Name:FULL SPECTRUM MEDICAL SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:C
Authorized Official - Last Name:BOWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-945-9193
Mailing Address - Street 1:720 NE 25TH AVE STE 38
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-2237
Mailing Address - Country:US
Mailing Address - Phone:888-655-3332
Mailing Address - Fax:888-655-3332
Practice Address - Street 1:720 NE 25TH AVE STE 38
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-2237
Practice Address - Country:US
Practice Address - Phone:888-655-3332
Practice Address - Fax:888-655-3332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies