Provider Demographics
NPI:1265508618
Name:ENRIQUE MEDICAL EQUIPMENT DME CORP
Entity Type:Organization
Organization Name:ENRIQUE MEDICAL EQUIPMENT DME CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-884-2353
Mailing Address - Street 1:6801 NW 77TH AVE
Mailing Address - Street 2:#204-A
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33166-2851
Mailing Address - Country:US
Mailing Address - Phone:305-884-2353
Mailing Address - Fax:
Practice Address - Street 1:6801 NW 77TH AVE
Practice Address - Street 2:#204-A
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166-2851
Practice Address - Country:US
Practice Address - Phone:305-884-2353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1313178332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0878820001Medicare ID - Type Unspecified