Provider Demographics
NPI:1245738202
Name:BIPED MEDICAL
Entity Type:Organization
Organization Name:BIPED MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:LPED
Authorized Official - Phone:386-479-0261
Mailing Address - Street 1:3024 TEAK DR
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-3124
Mailing Address - Country:US
Mailing Address - Phone:386-479-0261
Mailing Address - Fax:
Practice Address - Street 1:70 SPRING VISTA DR STE 3
Practice Address - Street 2:
Practice Address - City:DEBARY
Practice Address - State:FL
Practice Address - Zip Code:32713-1817
Practice Address - Country:US
Practice Address - Phone:386-479-0261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-24
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment