Provider Demographics
NPI:1275590952
Name:SUPREME CARE EQUIPMENT, INC
Entity Type:Organization
Organization Name:SUPREME CARE EQUIPMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RENE
Authorized Official - Middle Name:
Authorized Official - Last Name:VAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-637-8871
Mailing Address - Street 1:2521-23 N W 27 AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142
Mailing Address - Country:US
Mailing Address - Phone:305-637-8871
Mailing Address - Fax:305-698-6348
Practice Address - Street 1:2521 23 N W 27 AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142
Practice Address - Country:US
Practice Address - Phone:305-637-8871
Practice Address - Fax:305-698-6348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1079670001Medicare ID - Type Unspecified