Provider Demographics
NPI:1255490363
Name:AMBOS MUNDOS INC.
Entity Type:Organization
Organization Name:AMBOS MUNDOS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NORRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ATESIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-586-5681
Mailing Address - Street 1:2319 W 74TH ST
Mailing Address - Street 2:APT 207
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-6873
Mailing Address - Country:US
Mailing Address - Phone:786-586-5681
Mailing Address - Fax:
Practice Address - Street 1:1150 NW 72ND AVE
Practice Address - Street 2:STE 411
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-1936
Practice Address - Country:US
Practice Address - Phone:305-418-8662
Practice Address - Fax:305-418-8662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies